Computational methods and systems for reporting information regarding appurtenances to wound dressings

ABSTRACT

Computational systems and methods for reporting information regarding appurtenances to wound dressings are described. A system can include an appurtenance to a wound dressing, including a substrate, a transmission unit, a selectively activated switch, and a projection of a size and shape to extend into an interior region of a wound dressing and configured to sample a fluid associated with a wound; a local unit, including a receiver configured to receive signals from the transmission unit, a transmitter configured to send signals to the transmission unit, a processor, non-volatile memory, and a power source; and a central assembly, including a processor, a receiver configured to receive signals from the local unit, and at least one user interface.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is related to and claims the benefit of theearliest available effective filing date(s) from the following listedapplication(s) (the “Related Applications”) (e.g., claims earliestavailable priority dates for other than provisional patent applicationsor claims benefits under 35 USC §119(e) for provisional patentapplications, for any and all parent, grandparent, great-grandparent,etc. applications of the Related Application(s)). All subject matter ofthe Related Applications and of any and all parent, grandparent,great-grandparent, etc. applications of the Related Applications,including any priority claims, is incorporated herein by reference tothe extent such subject matter is not inconsistent herewith.

RELATED APPLICATIONS

For purposes of the USPTO extra-statutory requirements, the presentapplication constitutes a continuation-in-part of U.S. patentapplication No. To Be Assigned, entitled APPURTENANCES FOR REPORTINGINFORMATION REGARDING WOUND DRESSINGS, naming Paul Duesterhoft, NicholasDykstra, Daniel Hawkins, Roderick A. Hyde, Jordin T. Kare, Eric C.Leuthardt, Elizabeth L. Schubert, Clarence T. Tegreene, and Lowell L.Wood, Jr. as inventors, filed 12 Apr. 2012, which is currentlyco-pending or is an application of which a currently co-pendingapplication is entitled to the benefit of the filing date.

The United States Patent Office (USPTO) has published a notice to theeffect that the USPTO's computer programs require that patent applicantsreference both a serial number and indicate whether an application is acontinuation, continuation-in-part, or divisional of a parentapplication. Stephen G. Kunin, Benefit of Prior-Filed Application, USPTOOfficial Gazette Mar. 18, 2003. The present Applicant Entity(hereinafter “Applicant”) has provided above a specific reference to theapplication(s) from which priority is being claimed as recited bystatute. Applicant understands that the statute is unambiguous in itsspecific reference language and does not require either a serial numberor any characterization, such as “continuation” or“continuation-in-part,” for claiming priority to U.S. patentapplications. Notwithstanding the foregoing, Applicant understands thatthe USPTO's computer programs have certain data entry requirements, andhence Applicant has provided designation(s) of a relationship betweenthe present application and its parent application(s) as set forthabove, but expressly points out that such designation(s) are not to beconstrued in any way as any type of commentary and/or admission as towhether or not the present application contains any new matter inaddition to the matter of its parent application(s).

SUMMARY

In one aspect, a system includes but is not limited to a system formonitoring a wound dressing, including: an appurtenance to a wounddressing, wherein the appurtenance includes one or more projectionsconfigured to be positioned into the wound dressing and configured tosample a fluid associated with a wound, a processor, and at least onetransmitter operably attached to the processor; and a local unitincluding a receiver for the at least one transmitter, at least oneprocessor operably attached to the receiver, and at least onecommunication unit operably attached to the processor. In one aspect, asystem includes but is not limited to a system for monitoring a wounddressing, including: an appurtenance to a wound dressing, including asubstrate, a transmission unit, a selectively activated switch, and aprojection of a size and shape to extend into an interior region of awound dressing; a local unit, including a receiver configured to receivesignals from the transmission unit, a transmitter configured to sendsignals to the transmission unit, a processor, non-volatile memory, anda power source; and a central assembly, including a processor, areceiver configured to receive signals from the local unit, and at leastone user interface. In one aspect, a system includes but is not limitedto a system for monitoring a wound dressing, including: an appurtenanceto a wound dressing, including a substrate, a transmission unit, aselectively activated switch, and a projection of a size and shape toextend into an interior region of a wound dressing and configured tosample a fluid associated with a wound; a local unit, including areceiver unit configured to receive signals from the transmission unit,a transmitter configured to send signals to the transmission unit, aprocessor, non-volatile memory, and a power source; a central assembly,including a processor, a receiver configured to receive signals from thelocal unit, a transmitter, and at least one user interface; and one ormore user indicator devices including a receiver configured to receivesignals from the central unit, a processor, non-volatile memory, and anindicator. In addition to the foregoing, other system aspects aredescribed in the claims, drawings, and text forming a part of thepresent disclosure.

In one aspect, a method of monitoring an appurtenance attached to awound dressing includes but is not limited to: transmitting a firstsignal configured to be received by an appurtenance attached to a wounddressing; receiving a first signal from the appurtenance; associating afirst time point with the receipt of the first signal; transmitting asecond signal configured to be received by the appurtenance; receiving asecond signal from the appurtenance; and associating a second time pointwith the receipt of the second signal. In one aspect, a method ofmonitoring an appurtenance attached to a wound dressing includes but isnot limited to: transmitting a first signal from a local unit, the firstsignal configured to be received by an appurtenance attached to a wounddressing; receiving a first signal from the appurtenance at the localunit; transmitting information regarding the first signal from the localunit to a central assembly; associating a first time point with thereceipt of the first signal; transmitting a second signal from the localunit, the second signal configured to be received by the appurtenance;receiving a second signal from the appurtenance at the local unit;transmitting information regarding the first signal from the local unitto a central assembly; and associating a second time point with thereceipt of the second signal. In one aspect, a method of monitoring anappurtenance attached to a wound dressing includes but is not limitedto: receiving a first transmission from a local unit, the firsttransmission including first information regarding an appurtenanceattached to a wound dressing; associating a first time point with thereceipt of the first transmission; associating wound dressing parameterswith the received first information regarding the appurtenance;determining, based on the associated wound dressing parameters and thereceived first information, a first status of the appurtenance;determining, based on the determined first status of the appurtenance, afirst response; saving into memory as a record of the appurtenance thefirst time point, the received first information and the associatedwound dressing parameters; receiving a second transmission from thelocal unit, the second transmission including second informationregarding the appurtenance attached to the wound dressing; associating asecond time point with the receipt of the second transmission;associating the record of the appurtenance with the received secondinformation regarding the appurtenance; determining, based on theassociated record and the received second information, a second statusof the appurtenance; determining, based on the determined second statusof the appurtenance, a second response; and saving into memory with therecord of the appurtenance the second time point and the received secondinformation. In addition to the foregoing, other method aspects aredescribed in the claims, drawings, and text forming a part of thepresent disclosure.

The foregoing summary is illustrative only and is not intended to be inany way limiting. In addition to the illustrative aspects, embodiments,and features described above, further aspects, embodiments, and featureswill become apparent by reference to the drawings and the followingdetailed description.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1 is a schematic of an appurtenance to a wound dressing in use witha wound.

FIG. 2A is a schematic of an appurtenance to a wound dressing prior toattachment to a wound dressing.

FIG. 2B is a schematic of an appurtenance to a wound dressing afterattachment to a wound dressing.

FIG. 3 is a schematic of an appurtenance to a wound dressing in use witha wound.

FIG. 4 is a schematic of an appurtenance to a wound dressing in use witha wound.

FIG. 5 is a schematic of an appurtenance to a wound dressing incommunication with a local unit.

FIG. 6 is a schematic of an appurtenance to a wound dressing incommunication with a local unit.

FIG. 7 is a schematic of an appurtenance to a wound dressing incommunication with a local unit and a central assembly.

FIG. 8 is a schematic of an appurtenance to a wound dressing incommunication with a local unit, a central assembly and a remote device.

FIG. 9 is a schematic of an appurtenance to a wound dressing incommunication with a local unit, a central assembly and a remote device.

FIG. 10 is a flowchart of a method.

FIG. 11 is a flowchart illustrating aspects of a method such as shown inFIG. 10.

FIG. 12 is a flowchart showing aspects of a method such as displayed inFIG. 10.

FIG. 13 is a flowchart illustrating aspects of a method such as shown inFIG. 10.

FIG. 14 is a flowchart showing aspects of a method such as illustratedin FIG. 10.

FIG. 15 is a flowchart illustrating aspects of a method such as shown inFIG. 10.

FIG. 16 is a flowchart displaying aspects of a method such asillustrated in FIG. 10.

FIG. 17 is a flowchart illustrating aspects of a method such as shown inFIG. 10.

FIG. 18 is a flowchart showing aspects of a method such as displayed inFIG. 10.

FIG. 19 is a flowchart illustrating aspects of a method such as shown inFIG. 10.

FIG. 20 is a flowchart illustrating aspects of a method such as shown inFIG. 10.

FIG. 21 is a flowchart showing aspects of a method such as displayed inFIG. 10.

FIG. 22 is a flowchart illustrating aspects of a method such as shown inFIG. 10.

FIG. 23 is a flowchart illustrating aspects of a method such as shown inFIG. 10.

FIG. 24 is a flowchart showing aspects of a method such as displayed inFIG. 10.

FIG. 25 is a flowchart illustrating aspects of a method such as shown inFIG. 10.

FIG. 26 is a flowchart of a method.

FIG. 27 is a flowchart illustrating aspects of a method such as shown inFIG. 26.

FIG. 28 is a flowchart showing aspects of a method such as displayed inFIG. 26.

FIG. 29 is a flowchart illustrating aspects of a method such as shown inFIG. 26.

FIG. 30 is a flowchart showing aspects of a method such as illustratedin FIG. 26.

FIG. 31 is a flowchart illustrating aspects of a method such as shown inFIG. 26.

FIG. 32 is a flowchart displaying aspects of a method such asillustrated in FIG. 26.

FIG. 33 is a flowchart illustrating aspects of a method such as shown inFIG. 26.

FIG. 34 is a flowchart showing aspects of a method such as displayed inFIG. 26.

FIG. 35 is a flowchart illustrating aspects of a method such as shown inFIG. 26.

FIG. 36 is a flowchart showing aspects of a method such as illustratedin FIG. 26.

FIG. 37 is a flowchart illustrating aspects of a method such as shown inFIG. 26.

FIG. 38 is a flowchart displaying aspects of a method such asillustrated in FIG. 26.

FIG. 39 is a flowchart of a method.

FIG. 40 is a flowchart illustrating aspects of a method such as shown inFIG. 39.

FIG. 41 is a flowchart showing aspects of a method such as displayed inFIG. 39.

FIG. 42 illustrates a system including circuitry.

FIG. 43 shows a system including circuitry.

FIG. 44 illustrates a system including circuitry.

FIG. 45 shows a system including circuitry.

FIG. 46 illustrates a system including circuitry.

FIG. 47 shows a system including circuitry.

DETAILED DESCRIPTION

In the following detailed description, reference is made to theaccompanying drawings, which form a part hereof. In the drawings,similar symbols typically identify similar components, unless contextdictates otherwise. The illustrative embodiments described in thedetailed description and drawings are not meant to be limiting. Otherembodiments can be utilized, and other changes can be made, withoutdeparting from the spirit or scope of the subject matter presented here.

The use of the same symbols in different drawings typically indicatessimilar or identical items.

A wound dressing 115, selected by a medical caregiver as appropriate insize, shape and type for the wound 100, has an appurtenance 120 attachedto generate an appurtenance affixed to a wound dressing combinationunit, 125. The appurtenance 120 can be attached to the wound dressing115 with a mechanical attachment, such as with attachments shaped likeprongs, barbs, bristles, spikes, or spurs. The appurtenance 120 can beattached to the wound dressing 115 with a chemical attachment, such as apressure-sensitive adhesive, a contact adhesive, or a quick-dryingadhesive. The appurtenance 120 is a separate and distinct element thatcan be attached to the wound dressing 115 in a manner sufficient foroperation during the use of a specific wound dressing 115. Theappurtenance 120 is a separate and distinct element that can be attachedto the wound dressing 115 in an irreversible manner. For example, theappurtenance-wound dressing combination unit, 125, can be disposed ofafter use. Immediate disposal after use can be desirable to minimizebiosafety, contamination and biohazard issues. The appurtenance 120 is aseparate and distinct element that can be attached to the wound dressing115 in a reversible manner. For example, the appurtenance-wound dressingcombination unit, 125, can be taken apart into its component wounddressing 115 and appurtenance 120 after use. For example, theappurtenance 120 can be configured for reuse with a new wound dressing115. The appurtenance 120 can be configured for reuse after treatment,such as after disinfection, cleaning, or sterilization. An appurtenance120 to a wound dressing 115 can be reused, for example, on a successionof wound dressings 115 used by the same patient.

The appurtenance 120 is configured for functional use only when attachedto the wound dressing 115. The appurtenance 120 is of a size, shape andmaterial for functional use only when attached to the wound dressing115. The appurtenance 120 is configured to operate in conjunction withthe wound dressing 115. The appurtenance 120 is appended to the wounddressing 115 to generate an appurtenance-wound dressing combination unit125, as illustrated in the lower right region of FIG. 1. Theappurtenance 120 includes at least one region that projects into thestructure of the wound dressing 115. In some embodiments, the regionthat projects into the structure of the wound dressing 115 is of a sizeand shape to be entirely enclosed within the structure of the wounddressing 115. In some embodiments, the region that projects into thestructure of the wound dressing 115 is of a size and shape to projectthrough the wound dressing 115, for example to a region adjacent to awound. In some embodiments, the region that projects into the structureof the wound dressing 115 is of a size and shape to project through thewound dressing 115, for example to a wound bed region. In someembodiments, the region that projects into the structure of the wounddressing 115 is of a size and shape to project through a portion of thewound dressing 115, for example to a sinus or cavity of the wound bed.In some embodiments, the region that projects into the structure of thewound dressing 115 is of a size and shape to project through a portionof the wound dressing 115, for example to a dressing placed within asinus or cavity of the wound bed. In some embodiments, the region thatprojects into the structure of the wound dressing 115 is of a size andshape to project through a portion of the wound dressing 115, forexample to a layer placed adjacent to the wound surface. Theappurtenance 120 affixed to the wound dressing 115 forms an integratedunit of the appurtenance and the wound dressing as a combination unit125 (see, e.g. FIGS. 2, 5, and 7-11). In some embodiments, the wounddressing-appurtenance combination unit 125 is not readily separable, andthe individual wound dressing 115 and appurtenance 120 are not suitablefor separation and individual use after they have been joined together.As illustrated in the lower portion of FIG. 1, once the appurtenance 120is affixed to the wound dressing 115, the appurtenance and the wounddressing together as a combination unit 125 are used to cover andmonitor the wound 100.

In some aspects, an appurtenance 120 to a wound dressing 115 isconfigured to monitor one or more aspects of a wound 100. Anappurtenance 120 to a wound dressing 115 can be used by a caregiver or apatient to monitor a wound 100. In some aspects, an appurtenance 120 toa wound dressing 115 is configured to monitor one or more aspects of awound dressing 115. An appurtenance 120 to a wound dressing 115 can beused by a caregiver, including a patient, to monitor a wound dressing115. An appurtenance 120 to a wound dressing 115 is configured to allowa user, such as a caregiver or patient, to monitor a wound dressing andthe adjacent wound without disturbing the wound dressing 115 such asthrough removing the dressing 115 from the patient's wound 100. Thisapproach, inter alia, improves comfort to the patient, reduces thechance of accidental infection in or contamination from uncoveredwounds, and minimizes time requirements in wound care. As describedfurther below, in some aspects, an appurtenance 120 to a wound dressing115 includes a transmitter that sends a signal to a device used by acaregiver or patient to monitor the wound dressing from the same room asthe patient. As also described further below, in some aspects, anappurtenance 120 to a wound dressing 115 includes a transmitter thatsends a signal to a device used by a caregiver remotely, such as througha pager, remote computing device, cell phone, or dedicated remotesignaling device. The signal transmitter sends a signal containinginformation associated a wound and/or adjacent wound dressing such thata caregiver is able to receive, directly or indirectly, informationrelating to monitoring a wound and adjacent wound dressing at a distancefrom the patient, without disturbing the patient and with minimal timespent analyzing the wound 100 or wound dressing 115.

As described further below, in some aspects, an appurtenance 120 to awound dressing 115 is part of a system configured to automaticallyprocess and save information relating to an appurtenance 120 and therelated wound dressing 115 to a medical record system, such as a medicalrecords database. This automatic process reduces the potential foraccidental loss or error in data entry regarding wound care, and reducesthe time required by a caregiver in data entry into a record.

The wound dressing with the affixed appurtenance combination unit 125 isused to cover the wound 100 on the body part 110. The wound dressingwith the affixed appurtenance combination unit 125 can be secured to thebody part 110 in a routine manner for the type of wound dressing 115generally, such as through adhesive integral to the wound dressing 115or with additional adhesive, wrappings, tapes or glues as generallyapplicable to the type of wound dressing 115 utilized in a given medicalsituation. Although not illustrated in FIG. 1, the wound dressing withthe affixed appurtenance combination unit 125 can similarly be removedusing standard removal procedures, such as with gentle pressure, gentlepulling, unwrapping, allowing it to loosen over time, or bio-compatiblesolvents. The appurtenances 120 described herein can be single-use anddisposable along with the affixed wound dressing 115. In someembodiments, the appurtenances 120 described herein can be removed froma first wound dressing and then reconditioned, such as through cleaningor sterilization, and reused with a second wound dressing. In someembodiments, an appurtenance 120 can be reused for multiple wounddressings used on a single wound from a patient. The appurtenances 120described herein are generally intended to be operable for the period oftime a given wound dressing 115 is in use under standard conditions andtime periods. After the wound dressing with the affixed appurtenancecombination unit, 125 is removed from the body part 110, it can bedisposed of as a unit with routine disposal methods.

It is envisioned that the appurtenances 120 described herein will beutilized while affixed to wound dressings 115 over wounds 100 of avariety of types, and operable to assist in the monitoring of wounds ofa variety of types. For example, appurtenances 120 can be used inconjunction with wound dressings 115 to assist in monitoring acutewounds, such as those resulting from accidental injury or surgery. Forexample, appurtenances 120 can be used in conjunction with wounddressings 115 to assist in monitoring wounds closed by primaryintention. For example, the appurtenances 120 can be used to assist inmonitoring wound dressings over surgical wounds, such as incisions andsurgical stitches. For example, the appurtenances 120 can be used toassist in monitoring wound dressings over acute wounds from injury, suchas burn injuries, lacerations, or penetrating wounds. For example,appurtenances 120 can be used in conjunction with wound dressings 115 toassist in monitoring wounds closed by secondary intention. Theappurtenances 120 can also be used to assist in monitoring wounddressings over chronic wounds, such as those arising from chronicmedical conditions and situations. For example, the appurtenances can beused to monitor the status of wound dressings covering venous legulcers, diabetic foot ulcers, pressure ulcers or arterial ulcers. See:“Advances in Wound Healing Techniques,” publication D11A, Frost andSullivan, 2008; “An Overview of Ulceration Wounds,” Publication M4BB-54,Frost and Sullivan 2009; and “US Advanced Wound Care Market,”Publication N71A-54, Frost and Sullivan 2010, which are eachincorporated herein by reference.

The appurtenances 120 described herein can be useful in conjunction withan affixed wound dressing as a combination unit 125 to monitor potentialproblems with a wound, such as excessive bleeding or other fluidformation that would be present in the wound dressing, or the presenceof conditions in the dressing that indicate infection in an adjacentwound. See: Collier, “Recognition and Management of Wound Infections,”World Wide Wounds, pages 1-9, (January 2004); and Gray, “Assessment,Diagnosis and Treatment of Infection,” Wounds UK, vol. 7, no. 2,supplement, (2011), which are each incorporated herein by reference. Forexample, some types of wound discharge can indicate infection. See, forexample, Cutting and Harding, “Criteria for Identifying WoundInfection,” Journal of Wound Care, vol. 3, no. 4, 198-201 (1994), whichis incorporated herein by reference. The appurtenances 120 as part ofcombination units 125 and related systems described herein can be usedin conjunction with readily available types of wound dressings tomonitor aspects of the affixed wound dressing, including parameters thatindicate that a person should physically examine the wound dressing,such as excessive wetness, dryness, an elapsed period of time, or thepresence of specific factors detected by one or more sensors of theappurtenance. The appurtenances 120 as well as related systems describedherein can be used in conjunction with readily available types of wounddressings to monitor aspects of the affixed wound dressing, includingindications that the wound dressing should be changed (i.e. excessivelywet, dry, or soiled).

The appurtenances described herein include transmission units configuredto transmit signals, and thereby report information regarding the statusof the affixed wound dressing or wound, to associated systems. Theresulting information reporting can be used, in some embodiments, tosupplement the medical record for a patient in an automated system andautomatic process. The resulting information reporting can be used, insome embodiments, to automatically notify a caregiver that the status ofthe wound dressing has altered, indicating that a person shouldphysically inspect the wound dressing.

As used herein, a caregiver includes at least one of a patient, acaregiver, and medical personnel. A caregiver can utilize someembodiments of the appurtenances and related systems described herein inrelation with multiple types of wound dressings. Appurtenances can befabricated in shapes and sizes to conform to a variety of standard wounddressing sizes, shapes and types. Appurtenances can be fabricated with,for example, transmission units, antennas and sensors appropriate foruse with a variety of wound dressings. Appurtenances can be fabricatedwith, for example, transmission units, antennas and sensors appropriatefor different medical situations and monitoring requirements.Appurtenances can be fabricated with, for example, one or moreprojections of a size, shape and material appropriate for use with avariety of wound dressings. While it is envisioned that everyappurtenance will not be appropriate for use with every wound dressing(for example due to size, shape or material compatibility), a givenappurtenance is expected to be suitable for use with a range ofpotential wound dressings. For example, a given appurtenance of aspecific size, shape and fabrication, including type of transmissionunit, sensors, and projection(s), should be suitable for use with avariety of wound dressings of conforming sizes, shapes and types.Generally, any specific appurtenance embodiment is not expected to onlyconform to use with a unique wound dressing of a specific size, shapeand type. Instead, it is expected that a specific appurtenanceembodiment will be suitable for use with a range of wound dressings.Similarly, it is expected that a specific appurtenance embodiment willbe suitable for use with a range of wound and wound dressing monitoringrequirements.

In the attached drawings, an appurtenance 120 is generally illustratedas affixed to an outer surface of a wound dressing 115, for example anouter surface distal to a surface of the body part 110 adjacent to thewound 100. However, in some embodiments, an appurtenance 120 can beconfigured to attach to one or more surfaces of a wound dressing 115adjacent to a surface of the body part 110 adjacent to the wound 100.For example, in embodiments wherein an appurtenance 120 is configured tobe attached to a wound dressing 115 of a substantially rectangular,ovoid, or raised conformation, an appurtenance 120 can be configured tobe attached to a side surface of the wound dressing 115. For example, inembodiments wherein an appurtenance 120 is configured to be attached toa wound dressing 115 with an unusually strong or thick outer coverlayer, the appurtenance 120 can be configured to attach to an undersideof the wound dressing 115. In some embodiments, an appurtenance isconfigured to attach to a surface of a wound dressing 115 in contactwith the surface of the body part 110.

For example, the appurtenances described herein can be configured to beaffixed to a dry gauze dressing, which can or can not include an outercover layer. For example, the appurtenances described herein can beconfigured to be attached to a dry silicone or other solid foamdressing, which can or can not include an outer cover layer. Forexample, the appurtenances described herein can be configured to beaffixed to a wound dressing used to close a small or thin wound orsurgical incision, such as a butterfly dressing (e.g. SteriStrip™adhesive strips, available from Nexcare™, part of 3M Corporation). Forexample, appurtenances such as those described herein can be configuredto be affixed to a dressing configured to maintain moisture or othermaterials adjacent to the wound surface. For example, appurtenances suchas those described herein can be configured to be used with hydrogelwound dressings, for example Aquaflo™ Hydrogel Wound Dressing by KendallCorporation, or Elasto-Gel™ Hydrogel Occlusive Dressing by SouthwestTechnologies. For example, appurtenances such as those described hereincan be affixed to wound dressings including hydrocolloids, for exampleDuoDERM CGF Sterile Hydrocolloid Dressing manufactured by DuoDERMCorporation. For example, appurtenances such as those described hereincan be configured to be used with wound dressings containing one or moremedicinal agents, such as antibiotics. For example, appurtenances suchas those described herein can be used with wound dressings impregnatedwith PHMB (Polyhexamethylene Biguanide), such as Telfa™ A.M.D.antimicrobial wound dressings, manufactured by Kendall Corporation. Forexample, appurtenances such as those described herein can be configuredto be used with wound dressings including ionic silver, such as Maxorb™Extra Ag wound dressings manufactured by Medline Corporation.Appurtenances such as those described herein can be configured to beaffixed to wound dressings over wounds wherein the tissue of the woundis being directly monitored using other devices, for example asdescribed in U.S. Pat. No. 6,963,772 to Bloom et al., titled“User-retainable Temperature and Impedance Monitoring Methods andDevices,” which is incorporated herein by reference. Appurtenances suchas those described herein can be configured to be affixed to wounddressings over wounds wherein the patient is being directly monitoredusing other devices, for example as described in U.S. Pat. No. 7,030,764to Smith and Cooper, titled “Apparatus and Method for Reducing the Riskof Decubitus Ulcers;” U.S. Pat. No. 7,297,112 to Zhou et al., titled“Embedded Bio-Sensor System;” U.S. Pat. Nos. 7,372,780, 8,014,234 and7,813,226 to Braunberger, titled “Timing System and Device and Methodfor Making the Same;” U.S. Pat. No. 7,666,151 to Sullivan et al., titled“Devices and Methods for Passive Patient Monitoring;” U.S. Pat. No.7,703,334 to Cochran, titled “Bandage Type Sensor Arrangement andCarrier Assembly Therefore, and Method of Manufacture;” andInternational Patent Publication No. WO 2005/009328 to Nikolic, titled“ABT-Anti-Bedsore Timer,” which are each incorporated herein byreference. Appurtenances such as those described herein can also be usedin conjunction with a system to monitor assets within a health carefacility, for example as described in US Patent Application No.2007/0247316 to Wildman et al., titled “Article Locating and TrackingApparatus and Method,” which is incorporated herein by reference.

Wound dressings 115 such as those described herein are generally usedfor a relatively short period of time, on the order of hours or days,and then removed for disposal. Similarly, a wound dressing with anaffixed appurtenance combination unit 125 should be configured for useover the course of hours or days and then removed and disposed of usingstandard methods. A wound dressing with an affixed appurtenance issingle use and disposable after use. For example, a caregiver canrequire a new wound dressing every 24 hours (1 day) for an acute wound.Any wound dressing utilized in this type of situation would,consequently, be of a size and shape to remain affixed to the woundregion over the course of at least a 24 hour period and then removed fordisposal. An appurtenance to a wound dressing intended for use over thecourse of a 24 hour time period, similarly should be of a size, shape,material fabrication, and capabilities to function while affixed to thewound dressing over the 24 hour period that the dressing is in use. Asan additional example, a caregiver can decide that for another type ofwound, such as a chronic wound, the wound dressing needs to be removedand replaced once every 3 days, or every 4 days, or every 5 days, orevery 6 days, or every 7 days. Correspondingly, an appurtenance affixedto a wound dressing intended for use over the course of at least 3 to 7days should be of a size, shape, material fabrication, and capabilitiesto function while affixed to the wound dressing over at least the 3 to 7day period that the dressing is in use. In embodiments wherein anappurtenance is intended for reuse, such as reuse on a second orsubsequent wound dressing used over a wound, the appurtenance should beof a size, shape, material fabrication and capabilities to functionduring the entire intended use, including the time period of removalfrom a first wound dressing and application to a second wound dressing.

FIGS. 2A and 2B depict further aspects of some embodiments ofappurtenances to wound dressings. FIGS. 2A and 2B depict cross-sectionviews of an appurtenance 120 to a wound dressing 115. As illustrated inFIG. 2A, the appurtenance 120 includes a substantially planar sectionand a projection 200. The substantially planar section includes asurface 230 configured to substantially conform with an outer surface ofthe wound dressing 115. In some embodiments, the surface 230 of theappurtenance 120 configured to conform with an outer surface of thewound dressing 115 can include adhesive of a type expected to reversiblyor irreversibly adhere to the surface of the wound dressing 115. In someembodiments, the surface 230 of the appurtenance 120 configured toconform with an outer surface of the wound dressing 115 can includeadhesive of a type expected to adhere to the surface of the wounddressing 115 for a period of time, and to be removable. In someembodiments, the surface 230 of the appurtenance 120 configured toconform with an outer surface of the wound dressing 115 can includebarbs, hooks, pins, prongs or other extensions configured to adhere orfix onto the outer surface of the wound dressing 115. For example, anappurtenance 120 configured to conform with an outer surface of thewound dressing 115 can include barbs, hooks, pins, prongs or otherextensions that irreversibly adhere to the outer surface of the wounddressing 115, such as by imbedding into the outer surface. For example,an appurtenance 120 configured to conform with an outer surface of thewound dressing 115 can include barbs, hooks, pins, prongs or otherextensions that reversibly adhere to the outer surface of the wounddressing 115, such as by reversibly interacting with extensionsprojecting from the outer surface.

The appurtenance 120 depicted in FIGS. 2A and 2B includes a projection200. As shown in FIGS. 2A and 2B, the projection extends from a surface230 of the appurtenance 120 configured to conform with an outer surfaceof the wound dressing 115. The single projection depicted in FIGS. 2Aand 2B projects at an angle from the plane formed by the substantiallyplanar section of the appurtenance 120 conforming to the surface of thewound dressing 115. This angle is depicted in FIG. 2A as θ. In FIGS. 2Aand 2B, for example, the angle shown as θ is approximately 135 degrees.A single projection 200 is shown in FIGS. 2A and 2B. However, in someembodiments an appurtenance 120 can include a plurality of projections200. Depending on the embodiment, the projections 200 can also be at avariety of angles relative to the section of the appurtenance 120conforming to the surface of the wound dressing 115. For example, insome embodiments, one or more projections can be at angles less thanapproximately 135 degrees, between approximately 135 degrees andapproximately 90 degrees, or substantially at approximately 90 degreeangles relative to a planar section of the appurtenance 120. In someembodiments, an appurtenance 120 includes a substantially planar regionincluding a transmission unit, wherein the substantially planar regionis configured to conform with an outer surface of the wound dressing115, and one or more projections 200 projecting substantiallyperpendicular to the surface 230 configured to conform with an outersurface of the wound dressing 115. Depending on the embodiment, theprojections 200 can project in a direction substantially away from thesurface of the appurtenance configured to conform with an outer surfaceof the wound dressing 115 (e.g. as in FIGS. 2A and 2B), or angle in adirection substantially perpendicular to the surface 230 configured toconform with an outer surface of the wound dressing 115 of theappurtenance. Some embodiments include at least one projection 200 whichis curvilinear. Some embodiments include at least one projection 200which is a composite shape. In embodiments including one or moreprojections that are not substantially straight, an angle (e.g. 0 asillustrated in FIG. 2A) of the projection 200 can be determined by theangle formed at the base of the projection immediately adjacent to thesurface of the appurtenance configured to conform with an outer surfaceof the wound dressing 115.

The projection 200 can be a substantially hollow tubular structure.Although not illustrated in FIGS. 2A and 2B in this view, asubstantially hollow tubular structure of the projection 200 includes anopening on the distal end of the projection 200. While the projection200 depicted in FIGS. 2A and 2B can be a substantially tubularstructure, in some embodiments projections can be of different shapesand conformations. For example, a projection 200 can be solid, tubular,conical, cylindrical, tapered, curved, angular or other shape orcombination of shapes as appropriate to the specific embodiment.Embodiments including a plurality of projections can include projectionsof different sizes and shapes. A projection 120 can be substantiallystraight and form a substantially linear internal channel (e.g. asdepicted in FIGS. 2A and 2B), or it can be curved and form asubstantially curvilinear internal channel. The drawings illustratedherein are not to scale. The drawings illustrated herein representrelationships and shapes of the items described. Although not expresslyillustrated herein, a projection 200 can be relatively large relative tothe total size of the appurtenance. For example, the volume of aprojection or a group of projections attached to an appurtenance can be51%, 55%, 60%, 65%, 70%, 75%, 80%, 85%, 90%, 95% or 100% of the volumeof the portion of the appurtenance configured to conform with an outersurface of a wound dressing (e.g. the substantially planar region asillustrated in FIGS. 2A and 2B). Similarly, a projection 200 can berelatively small relative to the total size of the appurtenance. Forexample, the volume of a projection or a group of projections attachedto an appurtenance can be 49%, 45%, 40%, 35%, 30%, 25%, 20%, 15%, 10%,or 5% of the volume of the portion of the appurtenance configured toconform with an outer surface of a wound dressing (e.g. thesubstantially planar region as illustrated in FIGS. 2A and 2B). In someembodiments, a projection 200 is located at an edge region of thesubstantially planar region of the appurtenance 120, and in someembodiments a projection 200 is located substantially centrally to theplanar surface 230 of the appurtenance 120 configured to conform with anouter surface of the wound dressing 115. In some embodiments, asubstantially planar appurtenance 120 includes at least one projection200 wherein the entire appurtenance 120 is of a size and shape to besecured against an external surface of a wound dressing 115 with force,for example from a human thumb or finger.

In some embodiments, an appurtenance 120 can be fabricated with one ormore regions configured for the attachment of different modules. In someembodiments, an appurtenance 120 includes modules that are configuredfor removal and replacement. During fabrication, a basic appurtenancestructure can be utilized and different specific modules added asdesired in a particular embodiment. For example, an appurtenance 120 canbe fabricated with at least one region configured to attach aprojection. For example a region configured to attach a projection caninclude a region with a surface conforming to an outer surface of theprojection. For example a region configured to attach a projection caninclude a conduit configured to align with the hollow interior of theprojection. The region of the appurtenance 120 configured to attach aprojection can be configured for attachment of different projectiontypes, depending on the embodiment. For example, the region of theappurtenance 120 configured to attach a projection can be configured forattachment of projections of different lengths or different materials asdesired in the construction of a particular embodiment. In someembodiments, an appurtenance 120 can have multiple regions configuredfor attachment of multiple projections of different types. In someembodiments, an appurtenance 120 can have one or more removable antennamodules. For example, an appurtenance 120 can have one or more removablepower source modules, such as batteries or solar cells. In someembodiments, a module can include a spacer element, or a componentconfigured to assist in physically positioning one or more othermodules.

An appurtenance 120 can be fabricated from a variety of materials, asappropriate to an embodiment. An appurtenance 120 can be fabricated, forexample, substantially from a plastic material. For example, astructural portion, such as a shell or base can be fabricated from aplastic material. For example, one or more projections can be fabricatedfrom a plastic material. An appurtenance 120 can be fabricated, forexample, from one or more acrylics, polyesters, silicones, polyurethanesand halogenated plastics. An appurtenance 120 can include one or moreprojections 200 fabricated, for example, from one or more plasticmaterials. An appurtenance 120 can include one or more projections 200fabricated, for example, from one or more acrylics, polyesters,silicones, polyurethanes and halogenated plastics. An appurtenance 120can be fabricated from one or more bio-compatible materials, for examplebio-compatible plastics, resins, epoxies and metals. An appurtenance 120can be fabricated from one or more composite materials, such as plasticwith an overlay of epoxy or plastic with an overlay of one or moremetals. An appurtenance 120 including a transmission unit can include,for example, one or more metal components, for example as circuitry oras one or more antennas. An appurtenance 120 including a transmissionunit can include, for example, stainless steel, copper or zinc alloy. Anappurtenance 120 can be fabricated from one or more ceramic materials,such as within a transmission unit. Generally, it is envisioned thatmaterials with low weight will be suitable for a variety of appurtenanceembodiments, so as to reduce weight and associated physical stress on awound dressing. Similarly, it is envisioned that materials withsufficient strength and toughness to be fabricated into small and thincomponents will be desirable for fabrication of appurtenanceembodiments. As the appurtenances are to be permanently affixed to thewound dressings and disposed of with the wound dressings, materials thatdo not require special handling or disposal are preferable in mostembodiments.

In some embodiments, the appurtenance 120 includes a substrate, (e.g.250) that is configured to attach to the wound dressing 115. Forexample, the substrate can be configured as a support for other featuresof the appurtenance 120. In some embodiments, the substrate includes asubstantially planar structure wherein the area of surface 230 is lessthan the area of the wound dressing 115. In some embodiments, thesubstrate is configured to irreversibly attach directly to an externalsurface of the wound dressing 115. In some embodiments, the substrateincludes an adhesive on a surface conforming to an external surface ofthe wound dressing 115 (e.g. surface 230 in FIG. 2A). An adhesive may bea pressure-sensitive adhesive, a contact adhesive, or a drying adhesive.For example, the surface conforming to an external surface of the wounddressing 115 can include a glue, epoxy, sealant, mucilage, paste orother binder material. In some embodiments, the surface of the substrateconforming to an external surface of the wound dressing 115 can includean adhesive covered by a removable protective sheet configured fordetachment and exposure of the adhesive when the appurtenance 120 isattached to the wound dressing 115. In some embodiments, the surface 230of the substrate of the appurtenance 120 configured to conform with anouter surface of the wound dressing 115 can include barbs, hooks, pins,prongs or other extensions configured to adhere or fix into the outersurface of the wound dressing 115. In some embodiments, the surface 230of the substrate of the appurtenance 120 configured to conform with anouter surface of the wound dressing 115 can include a mixture orcombination of any of the above.

In some embodiments, the substrate includes a flexible material. Forexample, the substrate can include a pliable plastic, a woven fabricmaterial, soft mesh or other flexible material. In some embodiments, thesubstrate includes a rigid material. For example, the substrate caninclude at least one rigid plastic material in a location configured toprovide support for a portion of the appurtenance. For example, thesubstrate can include at least one rigid plastic material at a locationconfigured to attach a projection, the rigid plastic configured toprovide physical support for the attached projection. In someembodiments, the substrate includes at least one bio-compatiblematerial. For example, the substrate can include one or morebio-compatible plastic materials, one or more bio-compatible fabricmaterials, or one or more bio-compatible metals.

FIG. 2A depicts a cross section view of an appurtenance 120 adjacent toa wound dressing 115. As shown in FIG. 2A, the wound dressing 115includes a dressing layer 220 and an outer layer 210. Not all wounddressings 115 should be expected to include multiple layers, and it isto be expected that some wound dressings 115 substantially include onlya wound dressing material and not additional layers, structures orcoverings. However, as illustrated in FIGS. 2A and 2B, in someembodiments wound dressings 115 include a plurality of layers. Forexample, a wound dressing 115 can include one or more outer layers 210configured to protect and isolate the wound dressing layer(s) frommicrobes, external dirt and debris, dryness, wetness or other externalfactors. An outer layer can be fabricated from materials such as firmplastics or mesh materials. An outer layer can include a surface largerthan the surface of the wound dressing layer, and can include adhesiveson that surface configured to adhere the entire wound dressing to a bodysurface. A wound dressing 115 can include one or more layers of wounddressing 220 materials, such as gauze, films, foams, or sponges. A wounddressing 115 can include one or more layers of hydrogels, colloid gels,and medicinal agents impregnated within one or more layers of the wounddressing 220 or on a surface of the wound dressing 220 configured toface a wound.

A surface 230 of an appurtenance 120 can be configured to conform to thesurface of the outer layer 210 of a wound dressing 115. For example, thesurface can be of a size and shape that substantially conforms with thesurface of the wound dressing 115. A surface 230 of an appurtenance 120can include barbs, hooks, pins, prongs or other extensions configured tostick into the outer surface of the wound dressing 115. A surface 230 ofan appurtenance 120 can include one or more adhesives of a type toattach the appurtenance 120 to the wound dressing 115. A surface 230 ofan appurtenance 120 can be packaged with a removable cover over anadhesive layer.

FIG. 2B illustrates the appurtenance 120 and the wound dressing 115 ofFIG. 2A after the appurtenance 120 is affixed to the wound dressing 125.As illustrated in FIG. 2B, a projection 200 of an appurtenance 120 canbe configured to pierce through the outer layer 210 and into a wounddressing layer 220. A projection 200 of an appurtenance 120 can be of asize and shape to project from the outer surface of the wound dressing115 to within layers of the wound dressing 115. A projection 200 can beof a size and shape to extend into an interior region of the wounddressing 115. A projection 200 can be of a size and shape to projectwithin an interior region of the wound dressing 115. As shown in FIG.2B, a projection 200 can be of a size and shape to project underneathone or more superficial structures of the wound dressing 115 (such as anouter layer 210) when the wound dressing 115 is in use. A projection 200can be of a size and shape to project through a width of the wounddressing 115 when the appurtenance 120 is attached to the wound dressing125. Also as illustrated in FIG. 2B, a projection 200 extending withinthe layers of the wound dressing 125 can be positioned so that fluids,depicted as dotted arrows, may enter a hollow within the projection 200through capillary action through an opening in the projection 200. Aprojection 200 can include a substantially hollow structure. Aprojection 200 can include a substantially hollow structure with atleast one opening in the projection 200 allowing the flow of fluid intothe interior of the hollow projection 200. A projection 200 can includeat least one sensor substantially within the projection.

An appurtenance 120 to a wound dressing 115 can include one or moreprojections 200 configured to be positioned into the wound dressing 115,a processor, and at least one transmitter operably attached to theprocessor. The appurtenance 120 can include one or more sensors operablyattached to the processor. A projection 200 can include one or moresensors operably attached to the processor. A projection 200 can includeone or more fluid conduits between an interior of the wound dressing 115and the appurtenance 120. A fluid conduit refers to a conduit for fluid,such as a conduit of a size and shape to permit fluid flow through theconduit. A fluid conduit may actively promote flow through the fluidconduit, for example having interior dimensions that promote fluid flowthrough capillary action. A fluid conduit can be permissive for flow,with interior dimensions of sufficient size to allow fluid to flowthrough the fluid conduit. The at least one transmitter included in theappurtenance 120 can include a radio-frequency identification (RFID)transmitter. The at least one transmitter included in the appurtenance120 can include a near field communication (NFC) device. Theappurtenance 120 can include a transmission unit. The transmission unitcan include a transmitter and a receiver. The transmission unit caninclude an RFID unit. The transmission unit can include a near fieldcommunication (NFC) device. The transmission unit can include at leastone antenna. The transmission unit can include at least two antennas.The appurtenance 120 can include at least one indicator operablyattached to the transmission unit. For example, the appurtenance 120 caninclude an LED operably attached to the transmission unit, configured toilluminate when the transmission unit is in operation. The appurtenance120 can include non-volatile memory. The appurtenance 120 can includevolatile memory. The appurtenance 120 can include circuitry operablyconnected to the components of the appurtenance 120. The appurtenance120 can include at least one antenna. The appurtenance 120 can include areceiver. The appurtenance 120 can include at least one sensorconfigured to be responsive to changes in capacitance. The appurtenance120 can include at least one indicator.

A variety of sensors can be utilized in different embodiments of theappurtenances, depending on factors such as the intended use of theappurtenance, size, weight, cost, bio-compatibility, safety and ease ofdisposal. “Sensors,” as used herein, can be of a variety of typesdepending on the embodiment. One or more sensors can include at leastone sensor responsive to changes in capacitance, or a measure of theability of a configuration of materials to store electric charge. Ageneral review of biosensors which detect changes in the dielectricproperties of an electrode surface can be found in Berggren et al.,“Capacitive Biosensors,” Electroanalysis vol. 13, no. 3, 173-180,(2001), which is incorporated herein by reference. For example, one ormore sensors can include a micromechanical biosensor with a fixed-fixedbeam attached to an interdigitated capacitor (see, for example, Lim etal., “A Micromechanical Biosensor with Interdigitated CapacitorReadout,” Proceedings of the 2011 IEEE/ICME International Conference onComplex Medical Engineering, May 22-25, Harbin, China, which isincorporated herein by reference). Sensors may also include nanowirenanosensors, for example as described in Cui et al., “NanowireNanosensors for Highly Sensitive and Selective Detection of Biologicaland Chemical Species,” Science, vol. 293, 1289-1292 (2001), which isincorporated herein by reference. Sensors can include those utilizingantibodies secured to a graphene substrate. See Tehrani et al.,“Detection of Monoclonal Antibodies using Chemically Modified GraphiteSubstances,” IEEE Sensors 2010 Conference Proceedings, 428-431, (2010),which is incorporated herein by reference. In some embodiments, sensorsinclude aptamer-modified graphene field-effect transistors, see Ohno etal., “Graphene Field-Effect Transistors for Label-Free BiologicalSensors,” IEEE Sensors 2010 Conference Proceedings, 903-906, (2010),which is incorporated herein by reference. A sensor in an appurtenancemay interact with a sensor present in a wound dressing, for example asdescribed in U.S. Pat. No. 6,283,938 to McConnell, titled “MedicatingBandage and Controllable Permeable Membrane,” which is incorporatedherein by reference. A sensor can include a field effect transistor(FET), such as described in U.S. Pat. No. 7,507,675 to Zuilhof et al.,titled “Device Manufacturing Method and Device,” which is incorporatedherein by reference. A sensor can include a nano-cantilever device, suchas described in U.S. Pat. No. 7,612,424 to Espinosa and Ke, titled“Nanoelectromechanical Bistable Cantilever Device,” which isincorporated herein by reference.

The projections 200 can be functionally the same, or they can bedifferent. Projections at different levels and amounts into a wounddressing can be oriented, for example, to form conduits for fluid flowbetween different regions of a wound dressing and/or a wound bed regionand sensor(s) of the appurtenance. Projections can include the same typeof sensors, or be connected to the same type of sensors, or they caninclude different types of sensors, or be connected to different typesof sensors. For example, in some embodiments sensors detecting pHchanges in a wound dressing can be more desirable in a central locationof the appurtenance and sensors detecting wetness can be more desirableat an edge region of the appurtenance. In this example, pH changes canindicate potential infection in the central wound region, while edgewetness can indicate that the wound dressing is saturated and should bereplaced. Sensors for pH suitable for some embodiments are known. See,for example, the “flexible, iridium oxide pH sensor for wound dressingmaterial” project from the University of Texas at Arlington, theinformation sheet for which, with UTA reference number 08-21, is hereinincorporated by reference.

Some embodiments of an appurtenance 120 include a selectively activatedswitch. A “selectively actuated switch,” as used herein, refers to aswitch capable of allowing a transmission unit to transmit a signal inresponse to a sensor. An appurtenance can include, for example, at leastone sensor configured to respond to a substance within an interiorregion of a wound dressing and communicate a response to a selectivelyactivated switch. A selectively actuated switch may, for example, becoupled to a transmission unit that includes an RFID device. See, forexample, U.S. Pat. No. 7,411,505 titled “Switch Status and RFID Tag,”which is incorporated herein by reference. A selectively activatedswitch can be a binary switch, or a switch with substantially twosettings (i.e. “on” and “off”). A selectively actuated switch can beconfigured to be irreversible, or to irreversibly go from one state to asecond state. A selectively actuated switch can be configured to beresponsive to a change in capacitance. The selectively activated switchmay, for example, be operably connected to at least one sensor. Theselectively activated switch may, for example, be operably connected tothe transmission unit. The selectively activated switch may, forexample, be configured to alter the function of the transmission unit inresponse to a signal from a sensor. The selectively activated switchmay, for example, be a switch configured to respond to changes incapacitance. The selectively activated switch may, for example, be abinary switch (i.e. with only off/on capability). The selectivelyactivated switch may, for example, be a fluid conduit configured topermit the flow of fluid from the interior region of the wound dressingthrough the projection and into a location adjacent to the transmissionunit. A selectively activated switch can include, for example, asubstantially hollow structure. A selectively activated switch includinga conduit can be configured to modulate the activity of an antenna inthe transmission unit of the appurtenance 120 through fluid flow intocontact with the antenna.

FIG. 2B also illustrates that in some embodiments a cover 240 isattached to the surface of the appurtenance 120 as well as to thesurface of the wound dressing, such as to an outer layer of the wounddressing 210. An appurtenance 120 can include a substantially planarcover, the cover including an adhesive on a surface conforming to asurface of a wound dressing, the substantially planar cover configuredto cover a location where the projection extends into the wounddressing. A cover 240 can be fabricated, for example, from a flexibleplastic or mesh material. A cover 240 can be fabricated, for example,from an inflexible plastic or mesh material and configured in a size andshape to conform with the surfaces of the appurtenance 120 as well as tothe surface of the wound dressing 115. A cover 240 can include adhesiveon a surface facing the appurtenance and the wound dressing, theadhesive configured to attach the cover to the appurtenance and to thewound dressing. A cover 240 can be configured to stabilize the positionof the appurtenance 120 relative to the wound dressing 115 when theappurtenance is affixed to the wound dressing 125 (e.g. as in FIG. 2B).A cover 240 can be configured to secure the appurtenance 120 relative tothe wound dressing 115 when the appurtenance is affixed to the wounddressing 125 (e.g. as in FIG. 2B). A cover 240 can be configured to sealthe juncture between the appurtenance 120 and the wound dressing 115,for example from dirt, debris, wetness or microbes that may enter theinterior of the wound dressing if the juncture is not sealed. A cover240 can be configured to seal any potential gaps between the projection200 of the appurtenance 120 and the wound dressing 115, for example toseal any potential gaps from dirt, debris, wetness or microbes that mayenter the interior of the wound dressing if the gap is not sealed.

In some embodiments, an appurtenance 120 to a wound dressing 115 issubstantially sterilized prior to use. For example, the appurtenance 120can be treated with one or more chemical disinfectants or UV surfaceradiation for a period of time sufficient to substantially sterilize theappurtenance 120 prior to use. For example, the appurtenance 120 can betreated with one or more antimicrobial gasses, for example ethyleneoxide (ETO), prior to use. For example, the appurtenance 120 can betreated with a chemical sterilizing agent, such as hydrogen peroxide inliquid or vapor form, prior to use. For example, the appurtenance 120can be treated with steam as an anti-infective prior to use. In someembodiments, an appurtenance 120 to a wound dressing 115 includes asterile wrapper. For example, an appurtenance 120 to a wound dressing115 can be stored and/or transported within a sterile wrapper, such as afirm paper wrapper or a plastic film. A sterile wrapper configured forstorage and/or transport of an appurtenance can be treated to minimizecontamination, for example coated with one or more anti-microbialagents.

FIG. 3 illustrates additional aspects of some embodiments ofappurtenances to wound dressings. In some situations, a medicalcaregiver may choose a wound dressing that is not a single unit, but agroup of distinct units that together in situ on a body part form acomplete, composite wound dressing. For example, a medical caregiver maychoose a composite wound dressing made up from a group of butterflydressings (e.g. SteriStrip™ adhesive strips, available from Nexcare™).In some embodiments, a medical caregiver may choose a compressionbandaging system as part of a wound dressing. For example, a medicalcaregiver may choose a multi-layer compression bandaging system such asthe Profore™ System or the Proguide™ System. In some embodiments, amedical caregiver may choose a negative pressure wound therapy system,such as the Renasys™ system or the Pico™ system, or the V.A.C.™ system.As illustrated in FIG. 3, a composite wound dressing can include aplurality of wound dressings 115 as well as at least one wound dressingwith an affixed appurtenance combination unit 125. When the compositewound dressing is placed in position on a body part 110, such as a leg,the wound dressing with an affixed appurtenance combination unit 125 canbe included with the grouping of wound dressings 115.

FIG. 4 illustrates additional aspects of some embodiments ofappurtenances to wound dressings similar to that depicted in FIG. 3. Insome situations, a medical caregiver may choose a wound dressing that isnot a single unit, but a group of distinct units that together in situon a body part form a complete, composite wound dressing. For example, amedical caregiver may choose a composite wound dressing made up from agroup of butterfly dressings (e.g. SteriStrip™ adhesive strips). Asillustrated in FIG. 4, an appurtenance 120 can be positioned on a bodypart 110, such as a leg, in a region adjacent to a wound 100. A seriesof wound dressings 115 can be positioned around and over at least aportion of the appurtenance 120 and affixed to the appurtenance 120 toform a composite wound dressing with an affixed appurtenance combinationunit 125. For example, the appurtenance 120 can be interleaved with theindividual units of wound dressings 115 and affixed to at least onewound dressing to form a composite wound dressing with an affixedappurtenance combination unit 125.

FIG. 5 illustrates aspects of a system including a wound dressing withan affixed appurtenance combination unit 125. As shown in FIG. 5, awound dressing with an affixed appurtenance combination unit 125 isplaced over a wound on a body part 110 of a patient. For example, thebody part 110 may have been subject to a surgery, and therefore to havean acute wound. For example, the body part 110 can include an ulcer, andtherefore have a chronic wound. The wound dressing with an affixedappurtenance combination unit 125 receives signals 510 from a local unit540 and transmits signals 510 to the local unit 540. For example, thewound dressing with an affixed appurtenance combination unit 125 caninclude a passive RFID configured to transmit signals 510 afterreceiving signals 510 from a proximal RFID reader device in the localunit 540. The appurtenance includes one or more projections configuredto be positioned into the wound dressing, a processor, and at least onetransmitter operably attached to the processor (see, e.g. FIG. 2). Thelocal unit 540 includes a receiver for the at least one transmitter, atleast one processor operably attached to the receiver, and at least onecommunication unit operably attached to the processor (see, e.g. FIG. 6and associated text).

A local unit 540 can include a handheld device. For example, the localunit 540 can include a distinct handheld device. For example, the localunit 540 can be included as part of a larger handheld unit, for examplea tablet, a laptop, a cell phone, a personal communication device, orsimilar types of devices. A local unit 540 can be integrated with aninstitutional furnishing, such as a hospital bed, a medical stand, abedside table or a surgical cart. A local unit 540 can be of a size, ashape and a configuration for portable handheld use. A local unit 540can be configured to be attached to a mobile unit, such as the end of ahospital bed, a medical stand, a bedside table, a wheelchair, or similardevice. For example, a local unit can be integrated with a medical cart,as described in U.S. Pat. No. 7,667,606 to Packert et al., titled “RFEnabled Surgical Cart and Use of Same in Operating Room Environment,”which is incorporated herein by reference. A local unit 540 can beconfigured to be integrated into a furnishing. For example, a local unit540 can be integrated into a hospital bed, a bedside hospital monitor, abedside table, a medical chair, a medical table, or similar furnishing.A local unit 540 can include a display unit 520. In some embodiments,there can be a secondary device configured to relay signals to the localunit 540, for example as described in U.S. Pat. No. 7,986,235 toPosamentier titled “RFID Receive-Only System,” which is incorporatedherein by reference. A local unit 540 can include a communication unitconfigured to send signals to a central assembly (see, e.g. FIGS. 7 and8). The communication unit of a local unit 540 can include at least oneof: a visual display, a sound generator, a vibrating unit, and one ormore light displays. A local unit 540 can include at least one userinterface, such as a screen, monitor, touchscreen or voice recognitionelement. A local unit 540 can include an auditory signal generator. Alocal unit 540 can include an input device 530, for example a keyboard.Although the local unit 540 illustrated in FIG. 5 includes a keyboard asan input device 530, in some embodiments the input device 530 caninclude other types of input devices, for example a touchscreen, stylus,keypad, or voice recognition system. A local unit 540 can include apower source. For example, a local unit 540 can include a solar cell, abattery or connect to a building power supply through a wire connection.A user 500, such as a medical caregiver, operates the local unit 540.

A user 500 can include a medical caregiver, such as a nurse or doctor,or a patient, patient family member or other individual monitoring thewound dressing. Although user 500 is shown/described herein as a singleillustrated figure, those skilled in the art will appreciate that user500 can be representative of a human user, a robotic user (e.g.,computational entity), and/or substantially any combination thereof(e.g., a user can be assisted by one or more robotic agents) unlesscontext dictates otherwise. Those skilled in the art will appreciatethat, in general, the same can be said of “sender” and/or otherentity-oriented terms as such terms are used herein unless contextdictates otherwise. A user 500 may utilize a local unit 540 through auser interface, for example one or more buttons, a keyboard, atouchscreen, a voice recognition device, a stylus, or other means.

A local unit 540 can include a communication device including at leastone transmitter. A local unit 540 can include a radio-frequencyidentification (RFID) receiver. A local unit 540 can include a nearfield communication (NFC) device. A local unit 540 can be configured tosend and receive signals from a plurality of appurtenances. For example,a local unit 540 can be configured to send and receive signals frommultiple appurtenances affixed to wound dressings on a singleindividual. For example, a local unit 540 can be configured to send andreceive signals from multiple appurtenances affixed to wound dressingson multiple individuals in a defined area, such as a single room orregion of a room. A local unit 540 can be configured to send signals toone or more wound dressings with attached appurtenances 125automatically. For example, local unit 540 can be configured to sendsignals to one or more wound dressings with attached appurtenances 125at least one of: every 30 minutes; every hour; every 2 hours; or every 3hours. A local unit 540 can be configured to send signals to one or morewound dressings with attached appurtenances 125 on a schedule selectedby the user 500. For example, local unit 540 can be configured to sendsignals to one or more wound dressings with attached appurtenances 125on at least one of: an hourly schedule; a schedule of every 30 minutesfor 4 hours, followed by hourly signals; or a schedule provided by theuser through the user interface (e.g. the keyboard 530). A local unit540 can be configured to send signals to one or more wound dressingswith attached appurtenances 125 on a preset schedule which is selectedby the user 500. For example, local unit 540 can be configured to sendsignals to one or more wound dressings with attached appurtenances 125on at least one of: a schedule preset to monitor a wound after surgery;a schedule preset to monitor a chronic wound; an hourly schedule; aschedule of every 2 hours; a schedule of hourly during the day and every2 hours at night; or other preset schedules.

The signals 510 sent from the local unit 540 to the wound dressing withattached appurtenance unit 125 can be radio frequency signals in aparticular wavelength, or range of wavelengths. For example, the signalscan be in the UHF range, such as a UHF sub-range commonly used in aparticular geographic region. See, for example the “Worldwide RFID UHFMap” by Intelleflex Corporation (©2009), which is incorporated herein byreference. For example, the signals can be in a range of 902-928 MHz.For example, the signals can be in a range specified by an industrystandard. For example, the signals can be in the approximately 13.56megahertz (MHz) range, or within the ISO 14443 standard parameters. Forexample, the signals can be in the IEEE 802.11x standard or theBluetooth standard range. See, for example, U.S. Pat. No. 7,215,976 toBrideglall, titled “RFID Device, System and Method of OperationIncluding a Hybrid Backscatter-based RFID Protocol Compatible with RFID,Bluetooth and/or IEEE 802.11x Infrastructure,” which is incorporatedherein by reference. For example, the signals can be in theapproximately 131 kilohertz (KHz) range, for example as part of a RuBee™(IEEE standard 1902.1) system (equipment sold, for example, by VisibleAssets™, Inc). See for example: the description of RuBee™ systems fromthe Visible Assets™ webpage; Stevens et al., “RuBee (IEEE 1902.1)—ThePhysics Behind, Real-Time, High Security Wireless Asset VisibilityNetworks in Harsh Environments,” a white paper from Visible Assets™; andin US Patent Application No. 2007/0171076 to Stevens and Waterhouse,titled “Low-frequency Radio Tag Encapsulating System,” each of which areincorporated herein by reference.

Similarly, the signals 510 sent from the wound dressing with attachedappurtenance unit 125 to the local unit 540 can be one of the typesdescribed above in relation to signals 510 sent from the local unit 540.In some embodiments, the wound dressing with attached appurtenance unit125 includes a backscatter or reflective transmission device, and so thesignals 510 sent from the wound dressing with attached appurtenance unit125 to the local unit 540 can be backscatter or reflective signals. Forexample, as described in “Fundamental Operating Principles,” in Chapter3 of the RFID Handbook: Fundamentals and Applications in ContactlessSmart Cards and Identification, Klaus Finkenzeller, John Wiley & Sons,(2003), which is incorporated herein by reference herein.

The signals 510 transmitted from the local unit 540 or transmitted fromthe wound dressing with attached appurtenance unit 125 can be sent in afixed direction from the signal source. The wound dressing with attachedappurtenance unit 125 and the local unit 540 may each include markingsor other visible aspects directing a user how as to orient the wounddressing with attached appurtenance unit 125 and the local unit 540relative to each other for signal directionality.

In many embodiments, it is envisioned that the signal strength of asignal 510 transmitted from either the local unit 540 or transmittedfrom the wound dressing with attached appurtenance unit 125 will be suchthat the signal 510 will not travel a significant distance. The localunit 540 and the wound dressing with attached appurtenance unit 125 may,therefore, need to be placed in reasonably close proximity for signals510 to travel between the devices. For example, the signal 510transmitted from either the local unit 540 or transmitted from the wounddressing with attached appurtenance unit 125 can be such that thereceiver of such signals should be within the same room. For example,the signal 510 transmitted from either the local unit 540 or transmittedfrom the wound dressing with attached appurtenance unit 125 can be suchthat the receiver of such signals should be within 10 feet. For example,the signal 510 transmitted from either the local unit 540 or transmittedfrom the wound dressing with attached appurtenance unit 125 can be suchthat the receiver of such signals should be within 3 feet.

FIG. 6 illustrates aspects of a system including a wound dressing withan affixed appurtenance unit 125. As illustrated in FIG. 6, a wounddressing with an affixed appurtenance unit 125 is positioned over awound on a body part 110 of a patient. The wound dressing with anaffixed appurtenance unit 125 sends and receives signals 510 from alocal unit 540. The local unit 540 can be utilized by a user 500.

FIG. 6 illustrates aspects of the local unit 540. The local unit 540includes a housing, with connected user interface and input components(e.g. a display and keyboard). The local unit 540 can include aprocessor 600. The local unit 540 can include memory 610. The memory 610can include, for example, volatile and/or non-volatile memory. The localunit 540 can include at least one antenna 620. The local unit 540 caninclude circuitry 630, operably connected to the other components of thelocal unit. The local unit 540 can include one or more transmitters 640.The local unit 540 can include one or more receivers 650. The local unit540 can include one or more power sources 660, such as a battery, asolar cell, or a plug-in socket. The local unit 540 can include logic670. The local unit 540 can include other components 680, 690 asappropriate to a specific embodiment. The local unit 540 can include,for example, an application specific intelligent microsensor asdescribed in U.S. Pat. No. 6,889,165 to Lind et al., titled “ApplicationSpecific Intelligent Microsensors,” which is incorporated herein byreference herein.

FIG. 7 shows aspects of a system including a wound dressing with anaffixed appurtenance unit 125. As shown in FIG. 7, a wound dressing withan affixed appurtenance unit 125 is attached to a body part 110 of apatient over a wound. The wound dressing with an affixed appurtenanceunit 125 sends and receives signals 510 from a local unit 540. The localunit 540 can be utilized by a user 500.

Also as shown in FIG. 7, the local unit 540 may send and receive signals710 from a central assembly 705. The local unit 540 may send and receivesignals 710 with a wireless connection, as shown in FIG. 7, or the localunit 540 may send and receive signals 710 through a wire connection. Acentral assembly 705 includes at least one user interface device (e.g. akeyboard, touchscreen, display, etc.) which can be utilized by a systemuser 700. A system user 700 can include a medical caregiver, such as anurse or doctor, or a patient caregiver, or other individual monitoringthe wound dressing. Although system user 700 is shown/described hereinas a single illustrated figure, those skilled in the art will appreciatethat system user 700 can be representative of a human user, a roboticuser (e.g., computational entity), and/or substantially any combinationthereof (e.g., a user can be assisted by one or more robotic agents)unless context dictates otherwise. Those skilled in the art willappreciate that, in general, the same can be said of “sender” and/orother entity-oriented terms as such terms are used herein unless contextdictates otherwise.

FIG. 7 illustrates aspects of some embodiments of a central assembly705. A central assembly 705 can include a processor, a receiverconfigured to receive signals from the at least one communication unit,and at least one user interface. The central assembly 705 can include,for example, at least one transmitter 720. The central assembly 705 caninclude a transmitter configured to send signals to the local unit 540.The central assembly 705 can include a transmitter configured to sendsignals to one or more mobile devices. For example, the central assembly705 can include a transmitter configured to send signals to one or morecell phones, pagers, PDA devices, or mobile computing devices. Thecentral assembly 705 can include, for example, at least one receiver725. The central assembly 705 can include, for example, at least oneantenna 730. The central assembly 705 can be configured to receivesignals from a plurality of local units 540. For example, a centralassembly 705 can be configured to receive signals from all of the localunits in a hospital, nursing home, care facility, or a section thereof.The central assembly 705 can be configured to send signals to aplurality of local units 540. For example, a central assembly 705 can beconfigured to send signals to all of the local units in a hospital,nursing home, care facility, or a section thereof. The central assembly705 can include, for example, memory, which can include volatile and/ornon-volatile memory. The central assembly 705 can include, for example,circuitry 740. The circuitry 740 can be operably connected to othercomponents of the central assembly 705. The central assembly 705 caninclude, for example, a power source 745. A power source 745 caninclude, for example, at least one battery, a plug-in connection, awireless power source, or a solar cell. The central assembly 705 caninclude, for example, a processor 750. The central assembly 705 caninclude, for example, logic 755. The central assembly 705 can include,for example, additional components 760, 765. The central assembly 705can include at least one display. The central assembly 705 can includeat least one indicator, such as a visible or auditory indicator.

A central assembly 705 can be located primarily or mainly in one or alimited number of machines, for example one or more computer servers. Acentral assembly 705 can be configured to interact with a computersystem. A central assembly 705 may interface with, or include, a2G-RFID-Based E-Healthcare system. See, for example, Chen et al., “A2G-RFID-Based E-Healthcare System,” IEEE Wireless Communications,February 2010, pages 37-43, which is incorporated herein by reference. Acentral assembly 705 may interface with, or include, a digitalmanagement system, for example as discussed in: Fisher, “IndoorPositioning and Digital Management: Emerging Surveillance Regimes inHospitals” in T. Monahan (Ed), Surveillance and Security: TechnologicalPolitics and Power in Everyday Life (pp. 77-88), New York: Routledge(2006); and Fisher and Monahan, “Tracking the Social Dimensions of RFIDSystems in Hospitals,” International Journal of Medical Informatics 77(2008) 176-183, which are each incorporated herein by reference. Acentral assembly 705 may interface with, or include, a drug trackingsystem, as described, for example, in “RFID Systems for PharmaceuticalDistributors to Meet the New FDA Regulations on Drugs,” white paper fromAbhisam Software, (2006), which is incorporated herein by reference.

FIG. 8 illustrates aspects of a system including a wound dressing withan affixed appurtenance unit 125. As shown in FIG. 8, a wound dressingwith an affixed appurtenance unit 125 is placed over a wound on a bodypart 110 of a patient. The wound dressing with an affixed appurtenanceunit 125 receives signals 510 from a local unit 540 and transmitssignals 510 to the local unit 540. The local unit 540 can be utilized bya user 500.

Also as shown in FIG. 8, the local unit 540 may send and receive signals710 from a central assembly 705. A system user 700 interacts with a userinterface device operably attached to the central assembly 705. Thecentral assembly 705 sends signals 820 to and receives signals 820 froma remote device 800. Although the signals 820 illustrated in FIG. 8 arewireless signals 820, in some embodiments the signals 820 can betransmitted through a wire connection. The remote device 800 can be, forexample, a dedicated remote device 800. The remote device 800 can be,for example, integrated with another device, such as a laptop, cellphone, tablet computing device, pager, PDA, or personal computingdevice. The remote device 800 can be configured to initiate a warningindicator when it receives a signal 820 from the central assembly 705regarding the wound dressing with an affixed appurtenance unit 125. Forexample, the remote device 800 can be configured to initiate a warninglight, display, auditory message, auditory tone, or vibration when itreceives a signal 820 from the central assembly 705 regarding the wounddressing with an affixed appurtenance unit 125. The remote device 800 isconfigured for use by a remote user 810. A remote user 810 can include amedical caregiver, such as a nurse or doctor, or a patient caregiver, orother individual monitoring the wound dressing. Although remote user 810is shown/described herein as a single illustrated figure, those skilledin the art will appreciate that remote user 810 can be representative ofa human user, a robotic user (e.g., computational entity), and/orsubstantially any combination thereof (e.g., a user can be assisted byone or more robotic agents) unless context dictates otherwise. Thoseskilled in the art will appreciate that, in general, the same can besaid of “sender” and/or other entity-oriented terms as such terms areused herein unless context dictates otherwise. The remote user 810 mayinitiate the remote device 800 to transmit a signal 820 to the centralassembly 705, for example a signal 820 indicating that a message hasbeen received regarding the wound dressing with an affixed appurtenanceunit 125.

FIG. 9 illustrates aspects of a system including a wound dressing withan affixed appurtenance unit 125. As illustrated in FIG. 9, a wounddressing with an affixed appurtenance unit 125 is placed over a wound ona body part 110 of a patient. The wound dressing with an affixedappurtenance unit 125 sends and receives signals 510 from a local unit540. The local unit 540 sends and receives signals 710 from a centralassembly 705. The central assembly 705 illustrated in FIG. 9 is in a“cloud” format, with a significant portion of its components distributedon a computer network. The central assembly 705 is configured tocommunicate with one or more interface devices 700, for example anindividual computer.

Depending on the embodiment, a cloud-based central assembly 705 caninclude a plurality of components as illustrated in FIG. 9. For example,a central assembly 705 can include logic 910. For example, a centralassembly 705 can include circuitry 920. The circuitry 920 can beoperably connected to other components of the central assembly 705. Forexample, a central assembly 705 can include memory 930. For example, acentral assembly 705 can include one or more power sources 940. Forexample, a central assembly 705 can include at least one processor 950.For example, a central assembly 705 can include other components 960.

Also as illustrated in FIG. 9, a central assembly 705 may communicatewith a remote device 800 through signals 970. Signals 970 can be sentand received by an aspect of the central assembly 705. Signals 970 canbe sent and received by the remote device 800. Although the signals 970illustrated in FIG. 9 are wireless signals, in some embodiments thecentral assembly 705 and a remote device 800 may communicate through awired connection. The remote device 800 can be, for example, a pager,cell phone, laptop, PDA, tablet, smart phone or other device. The remotedevice 800 can be operated by a remote system user 810. Some embodimentsinclude a plurality of remote devices 800, which can be operated by aplurality of remote system users 810.

FIG. 10 illustrates aspects of a method utilizing the appurtenancesdescribed herein. As shown in FIG. 10, a method of monitoring anappurtenance attached to a wound dressing includes steps. Block 1000illustrates the start of the method. Block 1010 shows transmitting afirst signal configured to be received by an appurtenance attached to awound dressing. For example, a first signal can be sent from atransmitter unit integral to a local unit. For example, a first signalcan be configured in a direction or in a wavelength configured to bereceived by an appurtenance attached to a wound dressing. Block 1020depicts receiving a first signal from the appurtenance. For example, theappurtenance can include a passive RFID device and the first signalreceived from the appurtenance can be the reflected signal from thetransmitted first signal configured to be received by the appurtenance.For example, the appurtenance can include circuitry that transmits asignal in response to the receipt of the transmitted first signal. Block1030 illustrates associating a first time point with the receipt of thefirst signal from the appurtenance. For example, a first time point caninclude a clock time point. For example, a first time point can includesetting a time counting device to a “start” or “time zero” setting.Block 1040 shows transmitting a second signal configured to be receivedby the appurtenance. For example, a transmitted second signal can be ofthe same wavelength as the first transmitted signal. For example, atransmitted second signal can be directed in essentially the samedirection as the first transmitted signal. Block 1050 depicts receivinga second signal from the appurtenance. For example, the appurtenance caninclude a passive RFID device and the second signal received from theappurtenance can be the reflected signal from the transmitted secondsignal configured to be received by the appurtenance. For example, theappurtenance can include circuitry that transmits a signal in responseto the receipt of the transmitted second signal. Block 1060 illustratesassociating a second time point with the receipt of the second signal.For example, a second time point can include a clock time point. Forexample, a second time point can include the elapsed time detected by atime counting device since another time point, such as a “start” or“time zero” setting. Block 1080 shows the end of the method.

A “transmitter unit,” as used herein, can be of a variety of units thatare configured to send and receive signals, such as signals carried aselectromagnetic waves. In embodiments where the appurtenance includes asubstrate, the transmission unit can be attached to a surface of thesubstrate, the transmission unit including circuitry and at least oneantenna, the transmission unit configured to transmit a signal. Atransmitter unit generally includes at least one antenna and associatedcircuitry. A transmitter unit can include a transmitter and a receiver.A transmitter unit can include volatile and/or non-volatile memory. Atransmitter unit can include a processor. A transmitter unit can includean energy source, such as a battery. In some embodiments of anappurtenance, it is desirable to include a self-compensating antenna,such as described in U.S. Pat. No. 7,055,754 to Forester, titled“Self-Compensating Antennas for Substrates having Differing DielectricConstant Values,” which is incorporated herein by reference. Atransmitter unit can be operably connected to a processor. A transmitterunit can be operably connected to a sensor. A transmitter unit can beconfigured to transmit a signal in response to an interrogation signal.A transmitter unit can include an energy harvesting unit, such as a unitconfigured to obtain energy from electromagnetic waves. A transmitterunit can include a transponder utilizing electromagnetic waves, forexample as described in “Fundamental Operating Principles,” in Chapter 3of the RFID Handbook: Fundamentals and Applications in Contactless SmartCards and Identification, Klaus Finkenzeller, John Wiley & Sons, (2003),which is incorporated herein by reference herein. A transmitter unit caninclude an oscillator and encoder configured to generate a programmablepulse position-modulated signal in the radio frequency range. See, forexample, U.S. Pat. No. 4,384,288 to Walton, titled “Portable RadioFrequency Emitting Identifier,” which is incorporated herein byreference. A transmitter unit can include a radio frequencyidentification device (RFID). A transmitter unit can be configured to bea transmitter of signals in the UHF range. A transmitter unit includingan RFID device can be configured to transmit signals in the UHF standardrange utilized in a global region, as illustrated in the “Worldwide RFIDUHF Map” by Intelleflex Corporation (©2009), which is incorporatedherein by reference. A transmitter unit can include a radio frequencyidentification device (RFID), which can be a passive RFID device, asemi-passive RFID device, or an active RFID device, depending on theembodiment. See, for example, Chawla and Ha, “An Overview of PassiveRFID,” IEEE Applications and Practice, 11-17 (September 2007), which isincorporated herein by reference herein. A transmitter unit can includea battery-assisted passive RFID device, such as sold by AlienTechnology®, Morgan Hill, Calif., such as described in the brochure fromAlien Technology® titled “Battery Assisted Passive Tags” andincorporated herein by reference herein. A transmitter unit can includeand optical transmitter unit. A transmitter unit can be configured totransmit at approximately 13.56 megahertz (MHz), or within the ISO 14443standard parameters. See Patauner et al., “High Speed RFID/NFC at theFrequency of 13.56 MHz,” presented at the First International EURASIPWorkshop on RFID Technology, pages 1-4, 24-25 Sep. 2007, Vienna Austria,which is incorporated herein by reference herein. A transmitter unit caninclude at least two antennas. A transmitter unit can include aself-compensating antenna system. An antenna can include dielectricmaterial configured to electrically interact with one or more antennas.See, for example, U.S. Pat. No. 7,055,754 to Forester, titled“Self-Compensating Antennas for Substrates Having Differing DielectricConstant Values,” which is incorporated herein by reference. Atransmitter unit can include a hybrid backscatter system configured tofunction in an RFID, IEEE 802.11x standard and Bluetooth system. See,for example, U.S. Pat. No. 7,215,976 to Brideglall, titled “RFID Device,System and Method of Operation Including a Hybrid backscatter-based RFIDProtocol Compatible with RFID, Bluetooth and/or IEEE 802.11xInfrastructure,” which is incorporated herein by reference. Atransmitter unit can be configured to transmit at approximately 131kilohertz (KHz), for example as part of a RuBee™ (IEEE standard 1902.1)system (sold, for example, by Visible Assets™, Inc). See for example:the description of RuBee™ systems from the Visible Assets™ webpage;Stevens et al., “RuBee (IEEE 1902.1)—The Physics Behind, Real-Time, HighSecurity Wireless Asset Visibility Networks in Harsh Environments,” awhite paper from Visible Assets™; and in US Patent Application No.2007/0171076 to Stevens and Waterhouse, titled “Low-frequency Radio TagEncapsulating System,” each of which are incorporated herein byreference. A transmitter unit can include a near field communication(NFC) device. A transmitter unit can include a Wireless Identificationand Sensing Platform (WISP) device, manufactured by Intel Corporation,such as described in the “WISP: Wireless Identification and SensingPlatform” webpage (downloaded on Oct. 28, 2011) incorporated herein byreference. A transmitter unit can be operably coupled to a sensor, suchas a sensor that detects changes in capacitance (see, e.g. Sample etal., “A Capacitive Touch Interface for Passive RFID Tags,” 2009 IEEEInternational Conference on RFID, 103-109 (2009), which is incorporatedherein by reference). A transmitter unit can be operably coupled to asensor, such as described in: Ruhanen et al., “Sensor-enabled RFID Tagand Handbook,” from Building Radio Frequency Identification for theGlobal Environment (2008); Sample et al., “Design of an RFID-BasedBattery-Free Programmable Sensing Platform,” IEEE Transactions onInstrumentation and Measurement, vol. 57, no. 11, 2608-2615 (2008);Yeager et al., “Wirelessly-Charged UHF Tags for Sensor Data Collection,”2008 IEEE International Conference on RFID, Apr. 16-17, 2008, pages320-327; U.S. Pat. Nos. 5,904,671 and 6,348,640 to Navot and Botton,each titled “Tampon Wetness Detection System;” U.S. Pat. No. 7,446,660to Posamentier titled “Passive Environmental RFID Transceiver;” and U.S.Pat. No. 5,704,352 to Tremblay and Buckles, titled “Implantable PassiveBio-Sensor,” which are each incorporated herein by reference. Atransmission unit can be operably coupled to a data storage unit, forexample as described in U.S. Pat. No. 7,825,776 to Smith and Haehnel,titled “Device Configuration with RFID,” and US Patent Application No.2009/0243813 to Smith at al., titled “Wireless Programming ofNon-Volatile Memory with Near-Field UHF Coupling,” which are eachincorporated herein by reference.

In some embodiments, the transmitter unit can include an acoustictransmitter. For example, a transmitter unit can include a piezoelectricspeaker. A variety of suitable piezoelectric speakers are available,including from Murata Manufacturing Co., Ltd., with North Americancorporate headquarters in Smyrna, Ga. (see, e.g. the Murata catalogtitled “Piezoelectric Sounds Components” labeled P37E and dated Jan. 28,2010, which is incorporated herein by reference). Some embodiments caninclude acoustic transmitter units such as those manufactured byAdvanced Telemetry Systems (headquartered in Isanti, Minn.) for thePacific Northwest National Laboratory (see, e.g. JSATS AcousticTransmitter information sheet from the Pacific Northwest NationalLaboratory, updated March 2010, which is incorporated herein byreference). In some embodiments, an appurtenance can include apiezoelectric speaker configured as part of an acoustic transmitter andalso to act as a signaling device (e.g. to generate a beeping noise inresponse to a signal from the processor).

In some embodiments, the transmitter unit can include an ultrasonictransmitter. In some embodiments, the transmitter unit can include anultrasonic transducer. Multiple examples of ultrasonic transmitters andtransducers are commercially available, often marketed under the term“ultrasonic sensors” as it is used in the industry (see, e.g. the Muratacatalog titled “Ultrasonic Sensor” labeled 515E and dated Oct. 31, 2008,which is incorporated herein by reference). The transmitter unit can beconfigured as part of an ultrasonic ranging system. See: Wang, “A DesignMethod of Ultrasonic Ranging System with High Accuracy,” Journal ofComputational Information Systems, 7: 7 pages 2444-2451 (2011), which isincorporated herein by reference. The transmitter unit can be configuredto communicate with an ultrasonic communication system. See: Chen andWu, “Ultrasonic System with Infrared Communication Technology,” Journalof Computers, vol. 6, no. 11, pages 2468-2475 (2011), which isincorporated herein by reference.

In some embodiments, the transmitter unit can include an opticaltransmitter. For example, an optical transmitter unit can include one ormore white light emitting diodes (LEDs). For example, an opticaltransmitter unit can include an infrared laser. In some embodiments,optical transmitter units can be desirable to minimize interference fromnearby electrical equipment, such as medical equipment. See: Kavehrad,“Sustainable Energy-Efficient Wireless Applications Using Light,” IEEECommunications Magazine, vol. 48, no. 12, pages 66-73, (2010); andFadlullah and Kavehrad, “Indoor High-Bandwidth Optical Wireless Linksfor Sensor Networks” Journal of Lightwave Technology, vol. 28, no. 21,pages 3086-3094 (2010), which are incorporated herein by reference.

FIG. 11 illustrates aspects of the method depicted in FIG. 10. FIG. 11illustrates that in some embodiments, block 1010 can include one or moreof optional blocks 1100, 1110, and 1120. For example, transmitting afirst signal configured to be received by an appurtenance attached to awound dressing, as shown in block 1010, can include transmitting a radiofrequency signal in the UHF range, as illustrated in block 1100. Block1100 illustrates transmitting a radio frequency signal in the UHF range.The UHF range signal can include, for example, a transmitted signal inthe 902-928 MHz range. FIG. 11 also illustrates that block 1010 caninclude optional block 1110. Block 1110 depicts transmitting a radiofrequency signal in the near field communication (NFC) range. Forexample, transmitting a radio frequency signal in the NFC range caninclude transmitting a signal in the ISO/IEC 14443 standard range. Forexample, transmitting a radio frequency signal in the NFC range caninclude transmitting a signal in an approximate range of 13.56 MHz. FIG.11 also shows that block 1010 can include optional block 1120. Block1120 depicts transmitting a first signal from a local unit in responseto an input at the local unit. For example, transmitting a first signalfrom a local unit can be in response to a user pushing a button on thelocal unit. For example, transmitting a first signal from a local unitcan be in response to a user touching a touchscreen on the local unit.

FIG. 12 shows aspects of the method depicted in FIG. 10. FIG. 12 depictsthat in some embodiments, block 1010 can include one or more of optionalblocks 1200 and 1210. Block 1200 illustrates accepting input regardingparameters for monitoring the wound dressing at a local unit; andtransmitting a first signal from the local unit in response to theparameters for monitoring the wound dressing. For example, a local unitmay accept input from a user that the wound dressing should be monitoredevery hour, and the first signal transmitted from the local unit at theend of the first hour. Block 1210 depicts transmitting a first signalfrom a local unit in accordance with a preset program of signaltransmission. For example, a local unit can be preset to send a signalevery 10 minutes, and the first signal can be transmitted 10 minutesafter the local unit is turned on.

FIG. 13 illustrates aspects of the method depicted in FIG. 10. FIG. 13shows that in some embodiments, block 1020 can include one or more ofoptional blocks 1300, 1310, 1320 and 1330. Block 1020 depicts receivinga first signal from the appurtenance. FIG. 13 illustrates that block1020 can include block 1300, showing receiving a radio frequency signalin the UHF range. Block 1020 can include block 1310, depicting receivinga radio frequency signal in the near field communication (NFC) range.Block 1020 can include block 1320, showing receiving a reflectivelytransmitted signal. For example, the appurtenance can include an RFIDdevice. Block 1020 can include block 1330, depicting receiving a signaltransmitted within a radial distance of no more than 1 meter. Forexample, several of the transmission technologies described herein areof effective limited range, such as within a radial distance of no morethan 1 meter, or not more than 2 meters, or no more than 3 meters.

FIG. 14 depicts aspects of the method depicted in FIG. 10. FIG. 13 showsthat in some embodiments, block 1030 can include one or more of optionalblocks 1400 and 1410. Block 1030 illustrates associating a first timepoint with the receipt of the first signal from the appurtenance. Block1030 can include block 1400, illustrating associating a clock timepoint. For example, associating a clock time point can includeassociating a specific time and date, such as 14:56 on Dec. 20, 2011.For example, associating a clock time point can include associating anelapsed clock time point, such as 1 hour since the system was activatedrelative to a given appurtenance. Block 1030 can include block 1410,showing associating a start time point.

FIG. 15 shows aspects of the method depicted in FIG. 10. FIG. 15 showsthat in some embodiments, block 1040 can include one or more of optionalblocks 1500, 1510, 1520, 1530 and 1540. Block 1040 shows transmitting asecond signal configured to be received by the appurtenance. Block 1500illustrates transmitting a second signal from a local unit. Block 1510shows transmitting a radio frequency signal in the UHF range. Block 1520depicts transmitting a second signal from a local unit in response to aninput at the local unit. For example, transmitting a second signal canbe in response to a user entering a command on the keyboard of a localunit. Block 1530 shows transmitting a second signal from a local unit inaccordance with a preset program of signal transmission. For example, alocal unit may have a preset program for transmitting a signalconfigured to be received by the appurtenance every 10 minutes. Block1540 illustrates allowing a preset period of time to elapse; andtransmitting the second signal after the preset period of time haselapsed. For example, a preset period of time can be every half-hour,and so the second signal can be transmitted after a half hour haselapsed since the last transmission.

FIG. 16 shows aspects of the method depicted in FIG. 10. FIG. 16 showsthat in some embodiments, block 1050 can include one or more of optionalblocks 1600, 1610, 1620 and 1630. Block 1050 depicts receiving a secondsignal from the appurtenance. Block 1050 can include optional block1600. Block 1600 illustrates receiving a radio frequency signal in theUHF range. Block 1610 depicts receiving a radio frequency signal in thenear field communication (NFC) range. Block 1620 shows receiving by alocal unit a second signal, wherein the second signal was emitted froman appurtenance no more than approximately 1 meter away from the localunit. Block 1630 illustrates receiving a reflectively transmittedsignal.

FIG. 17 illustrates aspects of the method depicted in FIG. 10. FIG. 17depicts that in some embodiments, block 1060 can include one or more ofoptional blocks 1700 and 1710. Block 1060 illustrates associating asecond time point with the receipt of the second signal. Block 1700illustrates associating a clock time point. For example, a clock timepoint, such as 17:50, can be associated with the receipt of the secondsignal. Block 1710 shows associating an elapsed time point. For example,an amount of elapsed time since the receipt of the first signal can beassociated with the receipt of the second signal.

FIG. 18 depicts further aspects of the method shown in FIG. 10. FIG. 18shows that in some embodiments, the flowchart illustrated in FIG. 10 caninclude one or more optional blocks 1800 and 1810. Block 1800 showsactivating an indicator integral to a local unit. For example, an LEDindicator integral to a local unit can be illuminated. For example, avibration emitter integral to a local unit can be activated. Block 1810depicts activating an indicator operably attached to a local unit. Forexample, an LED indicator operably attached to a local unit can beilluminated. For example, a vibration emitter operably attached to alocal unit can be activated.

FIG. 19 depicts further aspects of the method shown in FIG. 10. FIG. 19shows that in some embodiments, the flowchart illustrated in FIG. 10 caninclude one or more optional blocks 1900 and 1910. Block 1900illustrates comparing the second signal from the appurtenance with thefirst signal from the appurtenance to form a signal comparison;comparing the signal comparison with a preset table; and activating anindicator in accord with the preset table. For example, a preset tablecan be a “look-up” table. For example, a preset table can include arange of preset signal comparison values predetermined to besufficiently significant to notify a caregiver through activating anindicator on the local unit. Block 1910 shows associating the secondtime point with a time period; and activating an indicator in responseto the associated time period. For example, a time period can be apredetermined time period between manual checks by a caregiver. Forexample, a time period can be a predetermined time period that a wounddressing with an affixed appurtenance should be in place before it ischanged. For example, a time period can be one day, two days, or threedays.

FIG. 20 shows further aspects of the method shown in FIG. 10. FIG. 20illustrates that in some embodiments, the flowchart illustrated in FIG.10 can include optional block 2000. Block 2000 shows receivinginformation regarding an individual associated with the appurtenance;associating information regarding the individual with a set of woundcriteria; comparing the second signal with the set of wound criteria;and activating an indicator in response to the comparison. For example,the system may receive information that a particular individual is atrisk for developing infection, and associate the risk of infection withan elevated temperature. If the second signal includes informationindicating that the temperature of the wound dressing is elevatedbetween the first and second signal, an indicator on the local unit canbe activated. For example, the system may receive information that aparticular individual has an acute wound from a surgical intervention,and associate the information with a risk of bleeding. If the secondsignal includes information indicating that the moisture content of thewound dressing is elevated between the first and second signal, anindicator on the local unit can be activated.

FIG. 21 shows further aspects of the method shown in FIG. 10. FIG. 21illustrates that in some embodiments, the flowchart illustrated in FIG.10 can include one or more of optional blocks 2100 and 2110. Block 2100shows receiving information regarding an individual associated with theappurtenance; associating information regarding the individual with aset of time point criteria; comparing the second time point with the setof time point criteria; and activating an indicator in response to thecomparison. For example, a system may receive information that anindividual's wound dressing includes an epithelial growth factor, andassociate that information with the criteria that wound dressingsincluding an epithelial growth factor should be changed every 48 hours.The system may compare the second time point with this set of time pointcriteria, and activate the indicator when 48 hours has elapsed. Block2110 shows accepting input including an individual identifier associatedwith the appurtenance. For example, the system may accept input typedinto the local unit by a user identifying the patient, the region of thebody covered by the wound dressing, the type of wound dressing, or thecaregiver who applied the wound dressing with the affixed appurtenanceto the individual. For example, the system may accept input obtained bythe local unit transmitting an RFID signal to a patient identificationbracelet including an RFID tag and receiving the correspondingreflectively-transmitted signal including a specific identification codefrom the identification bracelet including an RFID tag worn by thepatient.

FIG. 22 illustrates aspects of the method shown in FIG. 10. FIG. 22shows that in some embodiments, the flowchart illustrated in FIG. 10 caninclude one or more of optional blocks 2200, 2210 and 2220. Block 2200illustrates accepting input including an individual identifierassociated with the appurtenance. For example, the appurtenance caninclude a preset individual identifier for that specific appurtenance.For example, a system user may give an appurtenance an individualidentifier when the appurtenance is affixed to a wound dressing. Block2210 shows recording information regarding at least one signal from theappurtenance in memory. For example, the time a signal is received canbe recorded in memory at a local unit. For example, informationcontained in a signal can be recorded in memory at a local unit. Block2220 shows recording at least one of the first time point and the secondtime point in memory. For example, the first time point can be recordedin non-volatile memory at the local unit. For example, the second timepoint can be recorded in non-volatile memory at the local unit.

FIG. 23 shows aspects of the method shown in FIG. 10. FIG. 23illustrates that in some embodiments, the flowchart depicted in FIG. 10can include one or more of optional blocks 2300 and 2310. Block 2300shows transmitting a third signal configured to be received by theappurtenance to the wound dressing; receiving a third signal from theappurtenance; associating a third time point with the receipt of thethird signal; and activating an indicator. For example, a system maymonitor an appurtenance affixed to a wound dressing for a longer periodthan allotted by two signals, and therefore at least a third signal canbe required. Block 2310 shows allowing a predetermined period of time toelapse between transmitting the first signal and transmitting the secondsignal. For example, a local unit may allow 30 minutes to elapse betweentransmitting the first signal and transmitting the second signal. Forexample, a local unit may allow 1 hour to elapse between transmittingthe first signal and transmitting the second signal.

FIG. 24 illustrates aspects of the method shown in FIG. 10. FIG. 24shows that in some embodiments, the flowchart depicted in FIG. 10 caninclude one or more of optional blocks 2400 and 2410. Block 2400 depictsaccepting input regarding a defined period of time; and allowing thedefined period of time to elapse prior to transmitting a signal from thelocal unit. For example, the local unit can be pre-programmed to send asignal after 30 minutes. For example, the local unit can bepre-programmed to send a signal every hour. For example, the local unitcan be pre-programmed to send a signal after 15 minutes has elapsed.Block 2410 illustrates transmitting a third signal configured to bereceived by the appurtenance; receiving a third signal from theappurtenance; associating a third time point with the receipt of thethird signal; and activating an indicator operably attached to the localunit.

FIG. 25 depicts aspects of the method shown in FIG. 10. FIG. 25 showsthat in some embodiments, the flowchart depicted in FIG. 10 can includeoptional block 2500. Block 2500 illustrates ending the steps; andpurging a memory of the first signal and the second signal. For example,a local unit may receive input to end the monitoring of a particularwound dressing-appurtenance unit, which can be removed for disposal, andthe local unit purged of the memory of the first signal and the secondsignal.

FIG. 26 illustrates aspects of a method of monitoring an appurtenanceattached to a wound dressing. The method of monitoring an appurtenanceattached to a wound dressing as depicted by the flowchart in FIG. 26relates to a local unit. The flowchart illustrates that the methodincludes steps. Block 2600 shows the start of the method. Block 2610depicts transmitting a first signal from a local unit, the first signalconfigured to be received by an appurtenance attached to a wounddressing. For example, a first signal can be transmitted from a localunit in a signal type configured to be received by an appurtenance, suchas an appurtenance including a RFID unit that can be configured toreceive a UHF signal in the range of 902-928 MHz. For example, a signalcan be transmitted from a local unit in a direction and at a distanceconfigured so that the signal can be received by an appurtenance. Block2620 illustrates receiving a first signal from the appurtenance at thelocal unit. For example, a local unit may receive a first signaltransmitted from the appurtenance. For example, a local unit may receivea first signal reflectively radiated from a RFID unit within theappurtenance. Block 2630 shows transmitting information regarding thefirst signal from the local unit to a central assembly. For example, alocal unit may transmit to a central assembly information regarding whenit sent the first signal. For example, a local unit may transmit to acentral assembly information regarding the received first signal fromthe appurtenance. Block 2640 illustrates associating a first time pointwith the receipt of the first signal. For example, a local unit mayassociate a clock time point with the receipt of the first signal fromthe appurtenance. For example, a local unit may associate an elapsedtime point with the receipt of the first signal from the appurtenance.Block 2650 depicts transmitting a second signal from the local unit, thesecond signal configured to be received by the appurtenance. Forexample, the second signal transmitted from the local unit can be of thesame frequency as the first signal transmitted from the local unit. Forexample, the second signal transmitted from the local unit can bepositioned in approximately the same direction as the first signaltransmitted from the local unit. Block 2660 shows receiving a secondsignal from the appurtenance at the local unit. For example, a localunit may receive a second signal from the appurtenance of asubstantially similar frequency as the first signal received from theappurtenance. Block 2670 depicts transmitting information regarding thefirst signal from the local unit to a central assembly. For example, alocal unit may transmit the time and information regarding a firstsignal to a central assembly. For example, a local unit may transmitinformation regarding the appurtenance source to a central assembly.Block 2680 shows associating a second time point with the receipt of thesecond signal. For example, a local unit may associate a clock timepoint with the receipt of the second signal. For example, a local unitmay associate an elapsed time point with the receipt of the secondsignal, such as the elapsed time since the first signal was received.Block 2690 illustrates the end of the method.

FIG. 27 shows aspects of the flowchart illustrated in FIG. 26. FIG. 27shows that in some embodiments, the flowchart can include one or more ofoptional blocks 2700 and 2710. Block 2610, illustrating transmitting afirst signal from a local unit, the first signal configured to bereceived by an appurtenance attached to a wound dressing, can includeone or more of optional blocks 2700 and 2710. Block 2700 showstransmitting a radio frequency signal in the UHF range. For example, asignal can be transmitted in the 902-928 MHz range. Block 2710 showstransmitting a radio frequency signal in the near field communication(NFC) range. For example, transmitting a radio frequency signal in theNFC range can include transmitting a signal in the ISO/IEC 14443standard range. For example, transmitting a radio frequency signal inthe NFC range can include transmitting a signal in an approximate rangeof 13.56 MHz.

FIG. 28 illustrates aspects of the flowchart shown in FIG. 26. FIG. 28illustrates that, in some embodiments, block 2610 can include one ormore of blocks 2800 and 2810. Block 2610 illustrates transmitting afirst signal from a local unit, the first signal configured to bereceived by an appurtenance attached to a wound dressing. Block 2800shows transmitting a first signal from the local unit in response to aninput at the local unit. For example, a user may input a command, suchas by pushing buttons integral to the local unit, which initiatestransmitting a first signal from the local unit. Block 2810 illustratestransmitting a first signal from the local unit in accordance with apreset program of signal transmission. For example, a local unit can beset to send a signal every 30 minutes, and therefore to transmit thefirst signal 30 minutes after a preset program of signal transmission isinitiated. For example, a local unit can be set to transmit the firstsignal directly after a preset program of signal transmission isinitiated.

FIG. 29 shows aspects of the flowchart shown in FIG. 26. FIG. 29 depictsthat, in some embodiments, block 2610 can include block 2900. Block 2610illustrates transmitting a first signal from a local unit, the firstsignal configured to be received by an appurtenance attached to a wounddressing. Block 2900 shows: accepting input regarding parameters formonitoring the wound dressing at a local unit; and transmitting a firstsignal from the local unit in response to the parameters for monitoringthe wound dressing. For example, a user may input parameters such as“monitor every 15 minutes” in to a local unit and the local unit maytransmit a first signal 15 minutes after receiving this input. Forexample, a user may input parameters such as “use protocol A” in to alocal unit and the local unit may transmit a first signal immediatelyafter receiving this input in accord with the protocol.

FIG. 30 shows aspects of the flowchart shown in FIG. 26. FIG. 30 depictsthat, in some embodiments, block 2610 can include block 3000. Block 2610illustrates transmitting a first signal from a local unit, the firstsignal configured to be received by an appurtenance attached to a wounddressing. Block 3000 illustrates: accepting input regarding parametersfor monitoring the wound dressing at the central assembly; transmittinginformation regarding the accepted input to the local unit; andtransmitting a first signal from the local unit in response to theinformation regarding the accepted input. For example, a user may inputinto the central assembly information regarding a wound type, and thecentral assembly may determine specific parameters for monitoring thattype of wound dressing from a look up table, and transmit informationregarding those specific parameters to a local unit. For example, acentral assembly may accept input that a patient has a chronic ulcer,and associate that with monitoring the wound dressing every hour for 3days based on a predetermined standard of care in a look-up table. Thecentral assembly may then transmit instructions to a local unitincluding that the local unit should transmit a first signal after 1hour. For example, a central assembly may accept input that a particularappurtenance-wound dressing unit should be signaled every 15 minutes,and the central assembly may then transmit instructions to a local unitincluding that the local unit should transmit a first signal 15 minutesafter the appurtenance-wound dressing unit is placed in use.

FIG. 31 illustrates aspects of the flowchart shown in FIG. 26. FIG. 31shows that, in some embodiments, block 2620 can include at least one ofoptional blocks 3100, 3110 and 3120. Block 2620 shows receiving a firstsignal from the appurtenance at the local unit. Block 3100 illustratesreceiving a radio frequency signal in the UHF range. For example, thelocal unit may receive a reflectively transmitted signal from an RFIDunit integral to the appurtenance in the UHF range. Block 3110illustrates receiving a radio frequency signal in the near fieldcommunication (NFC) range. For example, the appurtenance and the localunit can include integral NFC units. Block 3120 shows receiving areflectively transmitted signal. For example, the local unit may receivea reflectively transmitted signal from an RFID unit integral to theappurtenance.

FIG. 32 depicts aspects of the flowchart shown in FIG. 26. FIG. 32 showsthat, in some embodiments, block 2640 can include at least one ofoptional blocks 3200 and 3210. Block 2640 shows associating a first timepoint with the receipt of the first signal. Block 3200 illustratesassociating a clock time point. For example, associating “15:40 on May22, 2010” with the receipt of the first signal. Block 3210 showsassociating a start time point. For example, associating a time point“zero” or initiation of elapsed time detection.

FIG. 33 shows aspects of the flowchart shown in FIG. 26. FIG. 33 showsthat, in some embodiments, block 2650 can include at least one ofoptional blocks 3300 and 3310. Block 2650 depicts transmitting a secondsignal from the local unit, the second signal configured to be receivedby the appurtenance. Block 3300 shows transmitting a second signal fromthe local unit in response to an input at the local unit. For example, auser may press a button on the local unit to initiate transmission ofthe second signal. For example, a user may have preset a program ofmonitoring the appurtenance attached to the wound dressing, andtherefore that there should be a second signal transmitted at apredefined time period after the first signal transmission. Block 3310shows transmitting a second signal from the local unit in accordancewith a preset program of signal transmission. For example, a local unitcan be preset to transmit signals every 20 minutes while it is inoperation.

FIG. 34 depicts aspects of the flowchart shown in FIG. 26. FIG. 34 showsthat, in some embodiments, block 2660 can include optional block 3400.Block 2660 shows receiving a second signal from the appurtenance at thelocal unit. Block 3400 shows receiving a reflectively transmittedsignal. For example, a local unit may receive a reflectively transmittedsignal from an RFID unit integral to an appurtenance.

FIG. 35 shows aspects of the flowchart shown in FIG. 26. FIG. 35 showsthat, in some embodiments, block 2670 can include one or more ofoptional blocks 3500 and 3510. Block 2670 depicts transmittinginformation regarding the first signal from the local unit to a centralassembly. Block 3500 shows transmitting information through a wiredconnection. For example, the local unit can be able to send signals tothe central assembly through a wired connection. Block 3510 illustratestransmitting information through a wireless connection. For example, thelocal unit may transmit information to the central assembly withwireless signals.

FIG. 36 illustrates aspects of the flowchart shown in FIG. 26. FIG. 36shows that, in some embodiments, the flowchart can include one or moreof optional blocks 3600 and 3610. Block 3600 shows activating anindicator operably attached to the local unit. For example, a LED,auditory signal generator, or vibration unit operably attached to thelocal unit can be activated. For example, the activation can beinitiated by the processor in the local unit, in response to informationconveyed in a signal from the appurtenance, such as activate the LEDwhen no signal is detected for 10 minutes. For example, the activationcan be initiated by the processor in the local unit, in response to apreset program, such as sound the alarm after 48 hours. Block 3610 showstransmitting an indicator activation signal from the central assembly tothe local unit. For example, a central assembly may transmit anindicator activation signal to the local unit after a preset period oftime, such as 36 hours, indicating that a caregiver should manuallyinspect or change the wound dressing.

FIG. 37 shows aspects of the flowchart shown in FIG. 26. FIG. 37 showsthat, in some embodiments, the flowchart can include one or more ofoptional blocks 3700 and 3710. Block 3700 illustrates accepting inputregarding a defined period of time; and allowing the defined period oftime to elapse prior to transmitting a signal from the local unit to theappurtenance. For example, a local unit may accept input on atouchscreen regarding a 15 minute interval between signals to theappurtenance, and the local unit may allow 15 minutes to elapse beforethe next signal to the appurtenance. Block 3710 shows accepting inputregarding a defined period of time; allowing the defined period of timeto elapse prior to transmitting a signal from the local unit to thecentral assembly. For example, a user may input information into a localunit through a keyboard indicating that the status of the appurtenancebe reported to the central assembly every hour, and the local unit mayallow an hour to pass before sending a signal to the central assemblyincluding information regarding the status of the appurtenance.

FIG. 38 shows aspects of the flowchart shown in FIG. 26. FIG. 38 showsthat, in some embodiments, the flowchart can include optional block3800. Block 3800 shows transmitting a third signal from the local unit,the third signal configured to be received by the appurtenance;receiving a third signal from the appurtenance at the local unit;associating a third time point with the receipt of the third signal atthe local unit; and activating an indicator operably attached to thelocal unit. For example, the method steps illustrated in the flowchartof FIG. 26 and subsequent figures can be repeated a plurality of timesto monitor an appurtenance affixed to a wound dressing.

FIG. 39 depicts a flowchart illustrating aspects of a method ofmonitoring an appurtenance attached to a wound dressing. The methodillustrated in the flowchart of FIG. 39 includes a plurality of steps,as shown in the flowchart. The method illustrated in the flowchart ofFIG. 39 can be carried out, for example, by a central assembly, such asa central hospital or clinic computer system. Block 3910 shows receivinga first transmission from a local unit, the first transmission includingfirst information regarding an appurtenance attached to a wounddressing. For example, a first transmission from a local unit can bereceived by a central assembly, the first transmission includinginformation such as regarding when an appurtenance was applied to thewound dressing, the patient to whom the wound dressing was applied, thestatus of the patient, and any specific monitoring instructions from thewound caregiver. Block 3915 illustrates associating a first time pointwith the receipt of the first transmission. For example, a clock timepoint, such as 19:25, can be associated with the receipt of the firsttransmission from the local unit by the central assembly. Block 3920shows associating wound dressing parameters with the received firstinformation regarding the appurtenance. For example, a firsttransmission can include a code identifying a wound type as “123A,” andthe central assembly may use a look-up table to associate that code witha wound dressing that should be monitored every hour and changed every48 hours. Block 3925 illustrates determining, based on the associatedwound dressing parameters and the received first information, a firststatus of the appurtenance. For example, if the received firstinformation indicates that the appurtenance is functioning within normalparameters (i.e. sufficient signal strength, no warning indicators), afirst status of the appurtenance can be “green” or “OK.” For example, ifthe received first information indicates that the appurtenance is notfunctioning within normal parameters (i.e. insufficient signal strength,no signal or other indicators), a first status of the appurtenance canbe “needs to be checked” or “red.” Block 3930 depicts determining, basedon the determined first status of the appurtenance, a first response.For example, if the determined first status is “green” or “OK” a firstresponse can be to continue monitoring, or to send a “OK” signal to thelocal unit or the nursing station, or both. For example, if thedetermined first status is “needs to be checked” or “red,” a signalindicating that the wound dressing needs to be physically checked can besent to the local unit or to the nursing station, or both. Block 3935shows saving into memory as a record of the appurtenance the first timepoint, the received first information and the associated wound dressingparameters. For example, a central assembly may save into non-volatilememory the received information regarding the appurtenance. For example,a central assembly may save into a patient's medical record informationabout an appurtenance attached to a specific wound dressing, such as thefirst time point, the received first information and the associatedwound dressing parameters. Block 3940 illustrates receiving a secondtransmission from the local unit, the second transmission includingsecond information regarding the appurtenance attached to the wounddressing. For example, the second information can include a time point,signal strength information, and information from one or more sensors ofthe appurtenance. Block 3945 illustrates associating a second time pointwith the receipt of the second transmission. For example, a clock timepoint or an elapsed time point since the receipt of the firsttransmission. Block 3950 shows associating the record of theappurtenance with the received second information regarding theappurtenance. For example, an appurtenance-specific identificationnumber can be used to associate the record with the received secondinformation regarding the appurtenance. Block 3955 shows determining,based on the associated record and the received second information, asecond status of the appurtenance. For example, a predetermined set ofcriteria can be applied to determine a second status of theappurtenance, such as a loss of signal strength of a predeterminedamount, or an elapsed period of time. For example, a determined secondstatus can include “green,” or “no problem noted.” For example, adetermined second status can include “red,” or “notify caregiver toinspect wound dressing.” Block 3960 shows determining, based on thedetermined second status of the appurtenance, a second response. Forexample, if the determined second status includes “green,” or “noproblem noted,” a second response can be to send a “status OK” signal tothe local unit or to a nursing station, or both. For example, if thedetermined second status includes “red,” or “notify caregiver to inspectwound dressing,” a second response can be to transmit an “alert” messageto the local unit or to a nursing station, or both. Block 3965 showssaving into memory with the record of the appurtenance the second timepoint and the received second information. In the interests of space onthe Figure, a start and stop of the method are not illustrated in FIG.39.

FIG. 40 shows aspects of the flowchart shown in FIG. 39. FIG. 40illustrates that, in some embodiments, block 3915 can include one ormore of optional blocks 4000 and 4010. FIG. 40 depicts that, in someembodiments, block 3920 can include optional block 4015. FIG. 40illustrates that, in some embodiments, block 3945 can include one ormore of optional blocks 4020 and 4025. FIG. 40 shows that, in someembodiments, the flowchart can include one or more of optional blocks4030, 4035, 4040 or 4045. In the interests of space in FIG. 40, some ofthe text of FIG. 39 has been omitted but it should be considered thatthe blocks continue to represent the same aspects of the flowchart.Block 3915 illustrates associating a first time point with the receiptof the first transmission. Block 3915 can include one or more ofoptional blocks 4000 and 4010. Block 4000 shows associating a clock timepoint. For example, a day and time can be associated with the receipt ofthe first transmission. Block 4010 illustrates associating a relativetime point. For example, the elapsed time since the appurtenance wasactivated can be associated with the receipt of the first transmission.For example, the elapsed time since a surgery was performed (i.e. for anacute wound) can be associated with the receipt of the firsttransmission. Block 3920 shows associating wound dressing parameterswith the received first information regarding the appurtenance. Block3920 can include optional block 4015. Block 4015 depicts utilizing atable to determine the wound dressing parameters. For example, theprocessor of a central assembly may utilize a look-up table, or a set ofparameters associated with specific wound codes. FIG. 40 illustratesthat block 3945 can include one or more of optional blocks 4020 and4025. Block 3945 illustrates associating a second time point with thereceipt of the second transmission. Block 4020 shows associating a clocktime point. Block 4025 depicts associating a relative time point. FIG.40 illustrates that, in some embodiments, the flowchart can include oneor more of optional blocks 4030, 4035, 4040 or 4045. Block 4030illustrates accepting input regarding parameters for monitoring thewound dressing. For example, input identifying the type of wounddressing, and therefore its expected maximum length of use, can beaccepted. For example, a specific parameter can be accepted, such as“check every 20 minutes.” Block 4035 shows initiating a display of thefirst response. For example, a central assembly may transmit a signal toa nursing station to initiate a display on a monitor regarding thesuggested first response. For example, a central assembly may transmit asignal to a local unit to initiate a LED indicator light indicating thesuggested first response (i.e. red light for “check” and green light for“OK”). Block 4040 illustrates initiating a display of the secondresponse. For example, a central assembly may transmit a signal to anursing station to initiate a display on a monitor regarding thesuggested second response. For example, a central assembly may transmita signal to a local unit to initiate a LED indicator light indicatingthe suggested second response (i.e. red light for “check” and greenlight for “OK”). Block 4045 shows transmitting information to the localunit. For example, information can be transmitted from the centralassembly to the local unit.

FIG. 41 shows aspects of the flowchart shown in FIG. 39. FIG. 40illustrates that, in some embodiments, the flowchart may containoptional block 4110. In the interests of space in FIG. 41, some of thetext of FIG. 39 has been omitted but it should be considered that theblocks continue to represent the same aspects of the flowchart. Block4110 shows accepting input regarding a query of the determined secondstatus of the appurtenance; and initiating a display of the determinedsecond status. For example, input regarding a query can be accepted at auser interface operably attached to the central assembly, andinstructions can be sent to the user interface to initiate a display ona monitor of the determined second status. For example, input regardinga query can be accepted at a local unit and transmitted to the centralassembly, which may transmit a response that initiates a display of thedetermined second status at the local unit.

FIG. 42 illustrates aspects of a local unit 540. The local unit 540 canbe operated by a user 500. The local unit 540 can include circuitry. Asshown in FIG. 42, the local unit 540 can include circuitry 4200configured to monitor an appurtenance attached to a wound dressing. Thecircuitry 4200 includes circuitry 4210 for transmitting a first signalconfigured to be received by an appurtenance attached to a wounddressing. The circuitry 4200 includes circuitry 4220 for receiving afirst signal from the appurtenance. The circuitry 4200 includescircuitry 4230 for associating a first time point with the receipt ofthe first signal. The circuitry 4200 includes circuitry 4240 fortransmitting a second signal configured to be received by theappurtenance. The circuitry 4200 includes circuitry 4250 for receiving asecond signal from the appurtenance. The circuitry 4200 includescircuitry 4260 for associating a second time point with the receipt ofthe second signal.

FIG. 43 illustrates aspects of a local unit 540. The local unit 540 canbe operated by a user 500. The local unit 540 can include circuitry. Asshown in FIG. 43, the local unit 540 can include circuitry 4300configured to monitor an appurtenance attached to a wound dressing. Thecircuitry 4300 includes circuitry 4310 for transmitting a first signalfrom a local unit, the first signal configured to be received by anappurtenance attached to a wound dressing. The circuitry 4300 includescircuitry 4320 for receiving a first signal from the appurtenance at thelocal unit. The circuitry 4300 includes circuitry 4330 for transmittinginformation regarding the first signal from the local unit to a centralassembly. The circuitry 4300 includes circuitry 4340 for associating afirst time point with the receipt of the first signal. The circuitry4300 includes circuitry 4350 for transmitting a second signal from thelocal unit, the second signal configured to be received by theappurtenance. The circuitry 4300 includes circuitry 4360 for receiving asecond signal from the appurtenance at the local unit. The circuitry4300 includes circuitry 4370 for transmitting information regarding thefirst signal from the local unit to a central assembly. The circuitry4300 includes circuitry 4380 for associating a second time point withthe receipt of the second signal.

FIG. 44 illustrates aspects of a central assembly. The central assemblycan be operated by a user 700. The central assembly can includecircuitry. As shown in FIG. 44, the central assembly can includecircuitry 4400 configured for monitoring an appurtenance attached to awound dressing. The circuitry 4400 includes circuitry 4410 for receivinga first transmission from a local unit, the first transmission includingfirst information regarding an appurtenance attached to a wounddressing. The circuitry 4400 includes circuitry 4415 for associating afirst time point with the receipt of the first transmission. Thecircuitry 4400 includes circuitry 4420 for associating wound dressingparameters with the received first information regarding theappurtenance. The circuitry 4400 includes circuitry 4425 fordetermining, based on the associated wound dressing parameters and thereceived first information, a first status of the appurtenance. Thecircuitry 4400 includes circuitry 4430 for determining, based on thedetermined first status of the appurtenance, a first response. Thecircuitry 4400 includes circuitry 4435 for saving into memory as arecord of the appurtenance the first time point, the received firstinformation and the associated wound dressing parameters. The circuitry4400 includes circuitry 4440 for receiving a second transmission fromthe local unit, the second transmission including second informationregarding the appurtenance attached to the wound dressing. The circuitry4400 includes circuitry 4445 for associating a second time point withthe receipt of the second transmission. The circuitry 4400 includescircuitry 4450 for associating the record of the appurtenance with thereceived second information regarding the appurtenance. The circuitry4400 includes circuitry 4455 for determining, based on the associatedrecord and the received second information, a second status of theappurtenance. The circuitry 4400 includes circuitry 4460 fordetermining, based on the determined second status of the appurtenance,a second response. The circuitry 4400 includes circuitry 44565 forsaving into memory with the record of the appurtenance the second timepoint and the received second information.

FIG. 45 illustrates aspects of a computer system. The computer systemcan include a local unit, 540. The local unit 540 can be operated by auser 500. As shown in FIG. 45, a local unit 540 can include a computersystem 4500 configured to monitor an appurtenance attached to a wounddressing. The computer system can include 4510, one or more instructionsfor transmitting a first signal configured to be received by anappurtenance attached to a wound dressing. The computer system caninclude 4520, one or more instructions for receiving a first signal fromthe appurtenance. The computer system can include 4530, one or moreinstructions for associating a first time point with the receipt of thefirst signal. The computer system can include 4540, one or moreinstructions for transmitting a second signal configured to be receivedby the appurtenance. The computer system can include 4550, one or moreinstructions for receiving a second signal from the appurtenance. Thecomputer system can include 4560, one or more instructions forassociating a second time point with the receipt of the second signal.

FIG. 46 illustrates aspects of a computer system. The computer systemcan include a local unit, 540. The local unit 540 can be operated by auser 500. As shown in FIG. 46, a local unit 540 can include a computersystem 4600 configured to monitor an appurtenance attached to a wounddressing. The computer system can include 4610, one or more instructionsfor transmitting a first signal from a local unit, the first signalconfigured to be received by an appurtenance attached to a wounddressing. The computer system can include 4620, one or more instructionsfor receiving a first signal from the appurtenance at the local unit.The computer system can include 4630, one or more instructions fortransmitting information regarding the first signal from the local unitto a central assembly. The computer system can include 4640, one or moreinstructions for associating a first time point with the receipt of thefirst signal. The computer system can include 4650, one or moreinstructions for transmitting a second signal from the local unit, thesecond signal configured to be received by the appurtenance. Thecomputer system can include 4660, one or more instructions for receivinga second signal from the appurtenance at the local unit. The computersystem can include 4670, one or more instructions for transmittinginformation regarding the first signal from the local unit to a centralassembly. The computer system can include 4680, one or more instructionsfor associating a second time point with the receipt of the secondsignal.

FIG. 47 illustrates aspects of a computer system. The computer systemcan include a central assembly. The central assembly can be operated bya user 700. As shown in FIG. 47, a central assembly can include acomputer system 4700 configured to monitor an appurtenance attached to awound dressing. The computer system can include 4710, one or moreinstructions for receiving a first transmission from a local unit, thefirst transmission including first information regarding an appurtenanceattached to a wound dressing. The computer system can include 4715, oneor more instructions for associating a first time point with the receiptof the first transmission. The computer system can include 4720, one ormore instructions for associating wound dressing parameters with thereceived first information regarding the appurtenance. The computersystem can include 4725, one or more instructions for determining, basedon the associated wound dressing parameters and the received firstinformation, a first status of the appurtenance. The computer system caninclude 4730, one or more instructions for determining, based on thedetermined first status of the appurtenance, a first response. Thecomputer system can include 4735, one or more instructions for savinginto memory as a record of the appurtenance the first time point, thereceived first information and the associated wound dressing parameters.The computer system can include 4740, one or more instructions forreceiving a second transmission from the local unit, the secondtransmission including second information regarding the appurtenanceattached to the wound dressing. The computer system can include 4745,one or more instructions for associating a second time point with thereceipt of the second transmission. The computer system can include4750, one or more instructions for associating the record of theappurtenance with the received second information regarding theappurtenance. The computer system can include 4755, one or moreinstructions for determining, based on the associated record and thereceived second information, a second status of the appurtenance. Thecomputer system can include 4760, one or more instructions fordetermining, based on the determined second status of the appurtenance,a second response. The computer system can include 4765, one or moreinstructions for saving into memory with the record of the appurtenancethe second time point and the received second information.

The state of the art has progressed to the point where there is littledistinction left between hardware, software, and/or firmwareimplementations of aspects of systems; the use of hardware, software,and/or firmware is generally (but not always, in that in certaincontexts the choice between hardware and software can becomesignificant) a design choice representing cost vs. efficiency tradeoffs.There are various vehicles by which processes and/or systems and/orother technologies described herein can be effected (e.g., hardware,software, and/or firmware), and that the preferred vehicle will varywith the context in which the processes and/or systems and/or othertechnologies are deployed. For example, if an implementer determinesthat speed and accuracy are paramount, the implementer may opt for amainly hardware and/or firmware vehicle; alternatively, if flexibilityis paramount, the implementer may opt for a mainly softwareimplementation; or, yet again alternatively, the implementer may opt forsome combination of hardware, software, and/or firmware. Hence, thereare several possible vehicles by which the processes and/or devicesand/or other technologies described herein can be effected, none ofwhich is inherently superior to the other in that any vehicle to beutilized is a choice dependent upon the context in which the vehiclewill be deployed and the specific concerns (e.g., speed, flexibility, orpredictability) of the implementer, any of which may vary. Opticalaspects of implementations will typically employ optically-orientedhardware, software, and or firmware.

In some implementations described herein, logic and similarimplementations can include software or other control structures.Electronic circuitry, for example, may have one or more paths ofelectrical current constructed and arranged to implement variousfunctions as described herein. In some implementations, one or moremedia can be configured to bear a device-detectable implementation whensuch media hold or transmit a device detectable instructions operable toperform as described herein. In some variants, for example,implementations can include an update or modification of existingsoftware or firmware, or of gate arrays or programmable hardware, suchas by performing a reception of or a transmission of one or moreinstructions in relation to one or more operations described herein.Alternatively or additionally, in some variants, an implementation caninclude special-purpose hardware, software, firmware components, and/orgeneral-purpose components executing or otherwise invokingspecial-purpose components. Specifications or other implementations canbe transmitted by one or more instances of tangible transmission mediaas described herein, optionally by packet transmission or otherwise bypassing through distributed media at various times.

Alternatively or additionally, implementations can include executing aspecial-purpose instruction sequence or invoking circuitry for enabling,triggering, coordinating, requesting, or otherwise causing one or moreoccurrences of virtually any functional operations described herein. Insome variants, operational or other logical descriptions herein can beexpressed as source code and compiled or otherwise invoked as anexecutable instruction sequence. In some contexts, for example,implementations can be provided, in whole or in part, by source code,such as C++, or other code sequences. In other implementations, sourceor other code implementation, using commercially available and/ortechniques in the art, can be compiled/implemented/translated/convertedinto a high-level descriptor language (e.g., initially implementingdescribed technologies in C or C++ programming language and thereafterconverting the programming language implementation into alogic-synthesizable language implementation, a hardware descriptionlanguage implementation, a hardware design simulation implementation,and/or other such similar mode(s) of expression). For example, some orall of a logical expression (e.g., computer programming languageimplementation) can be manifested as a Verilog-type hardware description(e.g., via Hardware Description Language (HDL) and/or Very High SpeedIntegrated Circuit Hardware Descriptor Language (VHDL)) or othercircuitry model which may then be used to create a physicalimplementation having hardware (e.g., an Application Specific IntegratedCircuit). Those skilled in the art will recognize how to obtain,configure, and optimize suitable transmission or computational elements,material supplies, actuators, or other structures in light of theseteachings.

The foregoing detailed description has set forth various embodiments ofthe devices and/or processes via the use of block diagrams, flowcharts,and/or examples. Insofar as such block diagrams, flowcharts, and/orexamples contain one or more functions and/or operations, it will beunderstood by those within the art that each function and/or operationwithin such block diagrams, flowcharts, or examples can be implemented,individually and/or collectively, by a wide range of hardware, software,firmware, or virtually any combination thereof. In one embodiment,several portions of the subject matter described herein can beimplemented via Application Specific Integrated Circuits (ASICs), FieldProgrammable Gate Arrays (FPGAs), digital signal processors (DSPs), orother integrated formats. However, some aspects of the embodimentsdisclosed herein, in whole or in part, can be equivalently implementedin integrated circuits, as one or more computer programs running on oneor more computers (e.g., as one or more programs running on one or morecomputer systems), as one or more programs running on one or moreprocessors (e.g., as one or more programs running on one or moremicroprocessors), as firmware, or as virtually any combination thereof,and that designing the circuitry and/or writing the code for thesoftware and or firmware would be well within the skill of one of skillin the art in light of this disclosure. In addition, the mechanisms ofthe subject matter described herein are capable of being distributed asa program product in a variety of forms, and that an illustrativeembodiment of the subject matter described herein applies regardless ofthe particular type of signal bearing medium used to actually carry outthe distribution. Examples of a signal bearing medium include, but arenot limited to, the following: a recordable type medium such as a floppydisk, a hard disk drive, a Compact Disc (CD), a Digital Video Disk(DVD), a digital tape, a computer memory, etc.; and a transmission typemedium such as a digital and/or an analog communication medium (e.g., afiber optic cable, a waveguide, a wired communications link, a wirelesscommunication link (e.g., transmitter, receiver, transmission logic,reception logic, etc.), etc.).

In a general sense, the various embodiments described herein can beimplemented, individually and/or collectively, by various types ofelectro-mechanical systems having a wide range of electrical componentssuch as hardware, software, firmware, and/or virtually any combinationthereof; and a wide range of components that may impart mechanical forceor motion such as rigid bodies, spring or torsional bodies, hydraulics,electro-magnetically actuated devices, and/or virtually any combinationthereof. Consequently, as used herein “electro-mechanical system”includes, but is not limited to, electrical circuitry operably coupledwith a transducer (e.g., an actuator, a motor, a piezoelectric crystal,a Micro Electro Mechanical System (MEMS), etc.), electrical circuitryhaving at least one discrete electrical circuit, electrical circuitryhaving at least one integrated circuit, electrical circuitry having atleast one application specific integrated circuit, electrical circuitryforming a general purpose computing device configured by a computerprogram (e.g., a general purpose computer configured by a computerprogram which at least partially carries out processes and/or devicesdescribed herein, or a microprocessor configured by a computer programwhich at least partially carries out processes and/or devices describedherein), electrical circuitry forming a memory device (e.g., forms ofmemory (e.g., random access, flash, read only, etc.)), electricalcircuitry forming a communications device (e.g., a modem, communicationsswitch, optical-electrical equipment, etc.), and/or any non-electricalanalog thereto, such as optical or other analogs. Those skilled in theart will also appreciate that examples of electro-mechanical systemsinclude but are not limited to a variety of consumer electronicssystems, medical devices, as well as other systems such as motorizedtransport systems, factory automation systems, security systems, and/orcommunication/computing systems. Electro-mechanical as used herein isnot necessarily limited to a system that has both electrical andmechanical actuation except as context may dictate otherwise.

In a general sense, the various aspects described herein can beimplemented, individually and/or collectively, by a wide range ofhardware, software, firmware, and/or any combination thereof and can beviewed as being composed of various types of “electrical circuitry.”Consequently, as used herein “electrical circuitry” includes, but is notlimited to, electrical circuitry having at least one discrete electricalcircuit, electrical circuitry having at least one integrated circuit,electrical circuitry having at least one application specific integratedcircuit, electrical circuitry forming a general purpose computing deviceconfigured by a computer program (e.g., a general purpose computerconfigured by a computer program which at least partially carries outprocesses and/or devices described herein, or a microprocessorconfigured by a computer program which at least partially carries outprocesses and/or devices described herein), electrical circuitry forminga memory device (e.g., forms of memory (e.g., random access, flash, readonly, etc.)), and/or electrical circuitry forming a communicationsdevice (e.g., a modem, communications switch, optical-electricalequipment, etc.). The subject matter described herein can be implementedin an analog or digital fashion or some combination thereof.

At least a portion of the devices and/or processes described herein canbe integrated into an image processing system. A typical imageprocessing system generally includes one or more of a system unithousing, a video display device, memory such as volatile or non-volatilememory, processors such as microprocessors or digital signal processors,computational entities such as operating systems, drivers, applicationsprograms, one or more interaction devices (e.g., a touch pad, a touchscreen, an antenna, etc.), control systems including feedback loops andcontrol motors (e.g., feedback for sensing lens position and/orvelocity; control motors for moving/distorting lenses to give desiredfocuses). An image processing system can be implemented utilizingsuitable commercially available components, such as those typicallyfound in digital still systems and/or digital motion systems.

At least a portion of the devices and/or processes described herein canbe integrated into a data processing system. A data processing systemgenerally includes one or more of a system unit housing, a video displaydevice, memory such as volatile or non-volatile memory, processors suchas microprocessors or digital signal processors, computational entitiessuch as operating systems, drivers, graphical user interfaces, andapplications programs, one or more interaction devices (e.g., a touchpad, a touch screen, an antenna, etc.), and/or control systems includingfeedback loops and control motors (e.g., feedback for sensing positionand/or velocity; control motors for moving and/or adjusting componentsand/or quantities). A data processing system can be implementedutilizing suitable commercially available components, such as thosetypically found in data computing/communication and/or networkcomputing/communication systems.

One skilled in the art will recognize that the herein describedcomponents (e.g., operations), devices, objects, and the discussionaccompanying them are used as examples for the sake of conceptualclarity and that various configuration modifications are contemplated.Consequently, as used herein, the specific exemplars set forth and theaccompanying discussion are intended to be representative of their moregeneral classes. In general, use of any specific exemplar is intended tobe representative of its class, and the non-inclusion of specificcomponents (e.g., operations), devices, and objects should not be takenlimiting.

The herein described subject matter sometimes illustrates differentcomponents contained within, or connected with, different othercomponents. It is to be understood that such depicted architectures aremerely exemplary, and that in fact many other architectures can beimplemented which achieve the same functionality. In a conceptual sense,any arrangement of components to achieve the same functionality iseffectively “associated” such that the desired functionality isachieved. Hence, any two components herein combined to achieve aparticular functionality can be seen as “associated with” each othersuch that the desired functionality is achieved, irrespective ofarchitectures or intermedial components. Likewise, any two components soassociated can also be viewed as being “operably connected,” or“operably coupled,” to each other to achieve the desired functionality,and any two components capable of being so associated can also be viewedas being “operably couplable,” to each other to achieve the desiredfunctionality. Specific examples of operably couplable include but arenot limited to physically mateable and/or physically interactingcomponents, and/or wirelessly interactable, and/or wirelesslyinteracting components, and/or logically interacting, and/or logicallyinteractable components.

With respect to the use of substantially any plural and/or singularterms herein, those having skill in the art can translate from theplural to the singular and/or from the singular to the plural as isappropriate to the context and/or application. The varioussingular/plural permutations are not expressly set forth herein for sakeof clarity.

In some instances, one or more components can be referred to herein as“configured to,” “configured by,” “configurable to,” “operable/operativeto,” “adapted/adaptable,” “able to,” “conformable/conformed to,” etc.Those skilled in the art will recognize that such terms (e.g.“configured to”) can generally encompass active-state components and/orinactive-state components and/or standby-state components, unlesscontext requires otherwise.

While particular aspects of the present subject matter described hereinhave been shown and described, changes and modifications can be madewithout departing from the subject matter described herein and itsbroader aspects and, therefore, the appended claims are to encompasswithin their scope all such changes and modifications as are within thetrue spirit and scope of the subject matter described herein. Terms usedherein, and especially in the appended claims (e.g., bodies of theappended claims) are generally intended as “open” terms (e.g., the term“including” should be interpreted as “including but not limited to,” theterm “having” should be interpreted as “having at least,” the term“includes” should be interpreted as “includes but is not limited to,”etc.). It will be further understood by those within the art that if aspecific number of an introduced claim recitation is intended, such anintent will be explicitly recited in the claim, and in the absence ofsuch recitation no such intent is present. For example, as an aid tounderstanding, the following appended claims may contain usage of theintroductory phrases “at least one” and “one or more” to introduce claimrecitations. However, the use of such phrases should not be construed toimply that the introduction of a claim recitation by the indefinitearticles “a” or “an” limits any particular claim containing suchintroduced claim recitation to claims containing only one suchrecitation, even when the same claim includes the introductory phrases“one or more” or “at least one” and indefinite articles such as “a” or“an” (e.g., “a” and/or “an” should typically be interpreted to mean “atleast one” or “one or more”); the same holds true for the use ofdefinite articles used to introduce claim recitations. In addition, evenif a specific number of an introduced claim recitation is explicitlyrecited, those skilled in the art will recognize that such recitationshould typically be interpreted to mean at least the recited number(e.g., the bare recitation of “two recitations,” without othermodifiers, typically means at least two recitations, or two or morerecitations). Furthermore, in those instances where a conventionanalogous to “at least one of A, B, and C, etc.” is used, in generalsuch a construction is intended in the sense one having skill in the artwould understand the convention (e.g., “a system having at least one ofA, B, and C” would include but not be limited to systems that have Aalone, B alone, C alone, A and B together, A and C together, B and Ctogether, and/or A, B, and C together, etc.). In those instances where aconvention analogous to “at least one of A, B, or C, etc.” is used, ingeneral such a construction is intended in the sense one having skill inthe art would understand the convention (e.g., “a system having at leastone of A, B, or C” would include but not be limited to systems that haveA alone, B alone, C alone, A and B together, A and C together, B and Ctogether, and/or A, B, and C together, etc.). It will be furtherunderstood by those within the art that typically a disjunctive wordand/or phrase presenting two or more alternative terms, whether in thedescription, claims, or drawings, should be understood to contemplatethe possibilities of including one of the terms, either of the terms, orboth terms unless context dictates otherwise. For example, the phrase “Aor B” will be typically understood to include the possibilities of “A”or “B” or “A and B.”

With respect to the appended claims, the recited operations therein maygenerally be performed in any order. Also, although various operationalflows are presented in a sequence(s), it should be understood that thevarious operations can be performed in other orders than those which areillustrated, or can be performed concurrently. Examples of suchalternate orderings can include overlapping, interleaved, interrupted,reordered, incremental, preparatory, supplemental, simultaneous,reverse, or other variant orderings, unless context dictates otherwise.Furthermore, terms like “responsive to,” “related to,” or otherpast-tense adjectives are generally not intended to exclude suchvariants, unless context dictates otherwise.

EXAMPLES Example 1 An Appurtenance to a Wound Dressing Configured toDetect and Report Fluid in a Wound Dressing

An appurtenance to a wound dressing is constructed from a flexible thinplastic substrate which is configured in a substantially planar shape. Apassive RFID antenna is attached to a surface of the substrate withepoxy. Circuitry for the RFID is attached to the substrate with adhesiveand connected to the antenna with conductive ink (e.g., polymer withflecks of silver) as needed to create an operational RFID. Also a portfor a polyester tube with approximately 0.5 mm inside diameter ismounted in contact with the antenna with epoxy. The polyester tubeprojects away from the surface of the substrate for approximately 4millimeters (mm). Encapsulating epoxy material is used to cover the RFIDcircuit, the conductive ink, conductive epoxy and exterior of the tubeport. A space is maintained around the edge of the polyester tubeadjacent to the antenna. The space is configured to allow fluid to flowfrom the tube into contact with the surface of the antenna. The space isapproximately 1 mm high and of sufficient lateral dimensions to cover aregion of the antenna (e.g. 2-3 mm across). Methods and circuitry toconstruct passive RFID tags are described (see e.g., U.S. Pat. No.7,479,886 issued to Burr, titled “Antenna Capacitance for EnergyStorage” and Chawla, “An Overview of Passive RFID,” IEEE Applications &Practice, 11-17, (September 2007), which are each incorporated herein byreference).

The substrate of the appurtenance is attached to the outer surface of awound dressing with adhesive. A styrene copolymer pressure-sensitiveadhesive can be used. In addition, the distal end of the polyester tubeis pressed into the layers of the wound dressing with finger-tippressure (see FIG. 2B). The wound dressing is of sufficient thickness soas to maintain the end of the polyester tube within the layers of thewound dressing, allowing for both the length of the tube itself and theangle it projects from the substrate. For example, if the tube is 4 mmlong, the wound dressing can be 6 mm thick, or greater. For example, ifthe tube is 4 mm long, the wound dressing can be 4 mm thick if the tubeis placed at a sufficient angle to maintain the distal end of the tubewithin the wound dressing. The wound dressing with the appurtenance isplaced immediately over the wound and the RFID identity number, patientinformation, the time and date are entered into a central computersystem after interrogating the RFID tag with a RFID reader in a localunit and accessing the patient's electronic medical record. If thepatient is wearing an RFID identification device (such as a wristbandwith an embedded RFID), the patient information can be input into thesystem by scanning the identification device in association withscanning the appurtenance.

A RFID reader in a local unit proximal to the patient (e.g., on the edgepatient's hospital bed or on a bedside table) is used to periodicallyinterrogate the appurtenance on the wound dressing by transmitting asignal in the UHF range (e.g. 902-928 MHz). The local unit can be set tointerrogate the appurtenance on a regular schedule, for example every 5minutes, every 10 minutes, or every half hour. The local unit may alsobe set to interrogate the appurtenance on command by a user, such as anurse, orderly, or other medical caregiver. The appurtenance receivesthe incident UHF waves and harvests energy to activate the RFIDcircuitry and transmit a backscatter signal to the RFID reader. Thesignal encodes the identity of the RFID device and the signal reflectsthe status of the antenna. If moisture present in the wound dressingreaches levels sufficient for fluid to flow from the wound dressing intothe tube of the appurtenance and into contact with the RFID antenna ofthe appurtenance, contact with the fluid on the antenna will modulatefunction of the antenna. This modulation, which can be a complete lossof function or a reduction or alteration of the “dry” signal, notifiesthe system that the wound dressing should be checked by a medicalcaregiver. Excess moisture to the level of fluid flow into theappurtenance can be caused, by example, from the patient bleeding at thewound site, or excess wound exudates.

The RFID reader in the local unit receives signals from the appurtenanceRFID device and transmits signals to a central computer that convey: thepatient identity, time, date, and moisture status of the wound dressing.The central computer may notify caregivers, for example through amessage sent to the nursing station, if the antenna signal from theappurtenance is modulated in a subsequent query, or series of queries.The local unit may also indicate to a healthcare worker the need tochange a wound dressing based on the elapsed time since the wounddressing was applied (i.e. when the appurtenance was first “read” intothe system).

Example 2 An Appurtenance to a Wound Dressing Configured to Detect andReport Fluid Directly from the Wound or Wound Bed

An appurtenance to a wound dressing is constructed substantiallysimilarly as described in Example 1, above. However, the wound dressingis of sufficient thickness so as to allow the end of the polyester tubeto protrude through the layers of the wound dressing, allowing for boththe length of the tube itself and the angle it projects from thesubstrate. For example, if the tube is 6 mm long, the wound dressing canbe 4 mm thick, depending on the angle of the tube projection through thewound dressing. For example, if the tube is 4 mm long, the wounddressing can be 4 mm thick if the tube is placed at a sufficient angleto allow the distal end of the tube to be at the surface of, or protrudefrom, the wound dressing. The polyester tube should not protrude fromthe wound dressing in a manner to create a new injury or puncture in thewound or body part. In contrast, if a wound contains a region that is ahollow or depression relative to the adjacent body part surface, thepolyester tube can be positioned with its terminal region within thishollow or depression. The appurtenance and affixed wound dressing maythen be monitored substantially similarly as described in Example 1,above.

Example 3 An Appurtenance Inserted into a Wound Dressing to MonitorWound Healing and Infection is Constructed Using a Passive RFID Tag andSensors Inside an Enclosure of a Height and Width to Fit Substantiallywithin the Wound Dressing

An appurtenance for a wound dressing configured to monitor wound healingand infection is constructed with an enclosure structure surrounding theappurtenance components. The appurtenance to a wound dressing includes aprogrammable RFID sensor device. The device is constructed with a RFIDdevice on a printed circuit board with external sensors. For example,the device may contain a dipole antenna of 22-gauge copper magnet wire,a rectifier to convert incoming UHF energy into DC voltage, a capacitorto store the voltage, and a programmable microcontroller to performsensing and computation (see e.g., Sample et al., “Design of anRFID-Based Battery-Free Programmable Sensing Platform,” IEEE Trans.Instr. Meas. 57: 2608-2615, 2008 which is incorporated herein byreference). The RFID device may also have multiple sensors connected tothe microcontroller to detect wound healing and infection. Each sensorprojects into the lower portion of the appurtenance relative to theinsertion point into the wound dressing. The sensors are locatedsubstantially within the enclosure and adjacent to an opening in theenclosure. For example, a moisture sensor comprised of two electrodeslocated adjacent to an opening in the enclosure can be used to monitorthe amount of fluids (e.g., exudate and blood) inside the wound dressingemanating from the wound. The electrode-based moisture sensor correlatesmoisture levels and impedance in the sensor (see e.g., McColl et al.,“Monitoring Moisture without Disturbing the Wound Dressing,” Wounds UK5: 94-99, 2009 which is incorporated herein by reference). Woundmoisture levels are correlated with healing, and a rapid increase inmoisture level may indicate a microbial infection is present (see e.g.,U.S. Pat. No. 6,963,772 to Bloom et al. titled “User-RetainableTemperature and Impedance Monitoring Methods and Devices,” which isincorporated herein by reference). The RFID device includes a secondsensor configured to measure the temperature of the wound dressing, andby extension the adjacent wound region. For example, an external analogtemperature sensor can be connected to the microcontroller of the deviceand extend into the wound dressing to monitor the temperature of thewound dressing and adjacent wound region. RFID devices with externaltemperature sensors accurate to approximately 2° C. are described (seee.g., Sample et al., “Design of an RFID-Based Battery-Free ProgrammableSensing Platform,” IEEE Trans. Instr. Meas. 57: 2608-2615, 2008 which isincorporated herein by reference). Methods to use temperature sensors todetect the presence of microbial infections are known. For example, athermistor-based sensor is used to monitor the temperature of a woundand indicate the presence of an infection or normal wound healing (seee.g., U.S. Pat. No. 6,963,772 to Bloom et al. titled “User-RetainableTemperature and Impedance Monitoring Methods and Devices,” which isincorporated herein by reference).

The appurtenance to a wound dressing is constructed in a “thumb tack” or“rivet” shaped design. The device enclosure is approximately 1-2 cm indiameter at the top and includes a region approximately 5 mm long thatextends into the wound dressing. The enclosure contains thethermistor-based temperature sensor which is exposed to the woundsurface and the moisture sensor, both positioned adjacent to an openingin the enclosure. In addition, the appurtenance is constructed with apressure-sensitive adhesive on the underside of the flange at the topand barbs on the projection to hold the attachment firmly in place afterinsertion in the bandage. Methods and materials to construct RFID tagsand housings are described (see e.g., U.S. Pat. No. 6,693,513 to Tuttle,titled “Wireless Identification device, RFID Device with Push-On/PushOff Switch, and Method of Manufacturing Wireless Identification Device”and Sample et al., “Design of an RFID-Based Battery-Free ProgrammableSensing Platform,” IEEE Trans. Instr. Meas. 57: 2608-2615, 2008 whichare each incorporated herein by reference).

The wound dressing appurtenance is used to monitor healing and infectionof an individual's wound and to signal healthcare workers when the woundand the wound dressing need attention. The appurtenance is insertedmanually in the wound dressing, and the combination unit is placedimmediately over the wound to position the moisture and temperaturesensors in the wound dressing proximal to the wound. The attachmentreceives UHF waves (e.g., approximately at 902-928 MHz) from a RFIDreader in a local unit that is installed near the patient (e.g., within10-15 meters for optimal signal from UHF waves), for example on the bedor on the wall of the hospital room. The RFID device receives UHF wavestransmitted from the reader via the antenna, power harvesting circuitry,rectifying circuitry and a capacitor to empower the RFID device withdirect (DC) current at approximately 1.8 volts. The power is used todrive the microcontroller which energizes the sensors, collects andcomputes data from the sensors and transmits a unique identificationcode and the collected sensor data to the RFID reader; the time and dateof the signal transmission are also encoded and sent to the RFID reader.The local unit including the RFID reader includes circuitry andprocessors to transmit the data to a central computer where it isentered into an electronic medical record for the patient and also sentto a healthcare worker assigned to the patient or the room.

Patient information, the bandage attachment ID code and the program forsignal transmission from the local unit are entered in the centralcomputer system and verified when the bandage appurtenance is installedby an initial signal transmission from the local unit. For example, abandage appurtenance with a designated ID number is assigned to apatient by entering the ID number into the patient's electronic medicalrecord when the appurtenance is inserted in the patient's wounddressing. The healthcare worker may use a mobile computer, e.g., laptopcomputer, to enter the ID number, the type of wound, type of bandage andthe interrogation schedule for the local unit. The patient informationand the ID code are verified by an initial interrogation by the RFIDreader within the local unit.

Example 4 A Bandage Appurtenance System is Used to Monitor WoundDressings on a Patient with Recurrent Bacterial Infections

A patient with a history of methicillin resistant staphylococcus aureus(MRSA) infections is treated for a leg wound with a wound dressing andan appurtenance system that monitors the wound dressing for signs ofinfection and sends a signal when the wound dressing may need attentionfrom a caregiver. The appurtenance to the wound dressing system reportsdata on the status of the wound dressing locally (within 10 meters ofthe patient) to a local unit containing a RFID reader. The local unitthen processes the incoming signal and transmits information over anintranet or the internet to a central computer assembly. Theappurtenance to the wound dressing system includes: an appurtenance tothe wound dressing, which is a RFID sensor device; a local unitincluding a RFID reader which interrogates the attachment with UHF wavesand receives and transmits data; and a central computer assembly whichstores the data and transmits an alert for health caregivers in responseto the information transmitted by the local unit.

An appurtenance to the wound dressing is constructed including a RFIDdevice that contains a microcontroller and multiple sensors. Each of thesensors is substantially enclosed within a projection which extends intothe wound dressing when the appurtenance is in use. The RFID device isconstructed on a printed circuit board with external sensors. Forexample, the device may contain a dipole antenna of 22-gauge coppermagnet wire, a rectifier to convert incoming UHF energy into DC, acapacitor to store the current, and a programmable microcontroller(e.g., a MSP430™ microcontroller available from Texas Instruments,Dallas, Tex.) to perform sensing and computation (see e.g., Sample etal., “Design of an RFID-Based Battery-Free Programmable SensingPlatform,” IEEE Trans. Instr. Meas. 57: 2608-2615, 2008 which isincorporated herein by reference). The RFID device has ports on themicrocontroller to connect multiple sensors to detect wound healing andinfection. The appurtenance receives UHF waves (e.g., approximately at902-928 MHz) from a local unit containing a RFID reader that isinstalled near the patient (e.g., within 10-15 meters for UHF waves). Along range RFID reader operating in the UHF band with an input/outputinterface for the internet or the local area network is available fromGAO RFID Inc., Seattle, Wash. The RFID device in the appurtenancereceives UHF waves transmitted from the reader integrated into the localunit via the appurtenance antenna, power harvesting circuitry,rectifying circuitry and capacitor. The incoming UHF signal empowers theRFID device of the appurtenance with DC current at approximately 1.8volts. The power is used to drive the microcontroller which energizesthe sensors, collects and processes data from the sensors and makes atransmission. The appurtenance transmits a unique identification codewith the collected sensor data to the RFID reader in the local unit; thetime and date of the signal transmission are also encoded and sent tothe RFID reader.

Sensors which detect moisture, temperature and Staphylococcus aureusproteins are placed inside hollow tubes which project from the bottom ofthe bandage appurtenance into the wound dressing. Tubes approximately2-4 mm long, and approximately 5 mm in diameter project from theappurtenance. These projections contain the sensors and determine theireffective penetration into the wound dressing. For example, a moisturesensor comprised of two electrodes which extend into the wound dressingthrough a projection can be used to monitor the amount of fluids (e.g.,exudate and blood) emanating from the wound. Electrode-based moisturesensors are used to correlate wound moisture levels and impedance in thesensor (see e.g., McColl et al., “Monitoring Moisture without Disturbingthe Wound Dressing,” Wounds UK 5: 94-99, 2009 which is incorporatedherein by reference) while wound moisture levels are correlated withhealing. For example, a rapid increase in moisture level may indicate amicrobial infection is present (see e.g., U.S. Pat. No. 6,963,772 toBloom et al. titled “User-Retainable Temperature and ImpedanceMonitoring Methods and Devices,” which is incorporated herein byreference). A second projection tube contains a thermistor-basedtemperature sensor which projects to a region adjacent to the woundsurface. For example, an external analog temperature sensor can beconnected to the microcontroller of the device and extend into the wounddressing to monitor the temperature of the wound. The approximatedistance between the wound surface and the interior of the wounddressing can be taken into account when estimating temperature of theactual wound. RFID devices with external temperature sensors accurate toapproximately 2° C. are described (see e.g., Sample et al., “Design ofan RFID-Based Battery-Free Programmable Sensing Platform,” IEEE Trans.Instr. Meas. 57: 2608-2615, 2008 which is incorporated herein byreference). Methods to use temperature sensors to detect the presence ofmicrobial infections are known. For example, a thermistor-based sensoris used to monitor the temperature of a wound and indicate the presenceof an infection or normal wound healing (see e.g., U.S. Pat. No.6,963,772 to Bloom et al. titled “User-Retainable Temperature andImpedance Monitoring Methods and Devices,” which is incorporated hereinby reference). An average temperature taken over time, or a graphshowing temperature readings over time can be presented to a system userby the central assembly computing system.

To specifically detect S. aureus in the wound, a third sensor isconnected to the microcontroller and inserted in a tube projecting intothe wound dressing. A nano-cantilever device that signals electronicallywhen it binds a S. aureus antigen is constructed using a carbon nanotubeand a monoclonal antibody (see e.g., U.S. Pat. No. 7,612,424 to Espinosaand Ke titled “Nanoelectromechanical Bistable Cantilever Device,” whichis incorporated herein by reference). The nano-cantilever isfunctionalized with a monoclonal antibody specific forpoly-N-acetylglucosamine (PNAG), a S. aureus antigen (see Kelly-Quintoset al., “Characterization of the Opsonic and Protective Activity AgainstStaphylococcus aureus of Fully Human Monoclonal Antibodies Specific forthe Bacterial Surface Polysaccharide Poly-N-Acetylglucosamine” Infectionand Immunity 74: 2742-2750 (2006) which is incorporated herein byreference). Signals from the nano-cantilever, moisture sensor andtemperature sensor are received by the microcontroller and transmittedto the local unit via the integrated RFID reader.

The local unit transmits signals received from the appurtenance to thewound dressing to a central computer assembly that stores the data andalerts hospital caregivers if an infection is detected or the wounddressing needs attention. For example, if the patient's bandageappurtenance is interrogated by the RFID reader and the S. aureus sensor(i.e. nano-cantilever) signals that S. aureus antigen is detected in thewound dressing, the local unit including the RFID reader transmits theinformation to the central computer assembly that issues an alert (e.g.,email) to the nurses and/or doctors attending to the patient. Moreover,the wound dressing data is stored in the patient's electronic healthrecord. The local unit also has programs and circuitry to interrogatethe bandage appurtenance according to a predetermined schedule andreport back to the central computer assembly. The wound dressingappurtenance system interacts with healthcare personnel through thecentral computer assembly and records and stores information on thewound dressing, changes in the wound dressing, infections and woundhealing. An individual user may query the system for information, andthe system can be preset to report at a particular time (e.g. the startof the day, or the start of a medical work shift).

Example 5 An Individual with 2^(nd) Degree Burns on their Leg is Treatedwith Wound Dressings and a Wound Dressing Monitor System to Monitor theMoisture Level and Infection Status of the Burn Wounds

An individual has suffered 2^(nd) degree burn wounds that coverapproximately 200 cm² of the leg. Medical personnel have chosen anabsorbent wound dressing which removes excess exudates but retainsmoisture in the wound. For example, an antimicrobial wound dressing(e.g., Mepilex® Ag available from Molnlycke Health Care US, LLC,Norcross, Ga.) is applied as an inner layer over the wound and a gauzedressing is applied as an absorbent outer layer to hold the inner layerdressing in place. To monitor the wound dressing, 3 bandageappurtenances are inserted approximately every 5 cm over the length ofthe wound site to monitor different areas of the burn wound. Each wounddressing appurtenance has a unique RFID identifier, a microcontroller, amoisture sensor and bacterial sensors. The placement and identificationinformation for each appurtenance and the patient is read into thesystem with a local unit including an RFID reader at the time the wounddressing is placed on the patient's leg wound.

Each disposable wound dressing appurtenance includes a RFID device and asensor with a microcontroller to direct sensing in the wound dressing.The system also includes a local unit configured to interrogate thewound dressing appurtenances and to communicate information to a centralcomputer assembly for the wound monitoring system. A UHF RFID sensordevice with a microcontroller and external sensors (see e.g., Sample etal., “Design of an RFID-Based Battery-Free Programmable SensingPlatform,” IEEE Trans. Instr. Meas. 57: 2608-2615, 2008 which isincorporated herein by reference) is constructed with a plastic housingand projections which extend from the surface of the appurtenance intothe wound dressing. A projection contains a moisture sensor. Forexample, a moisture sensor comprised of two electrodes which projectinto the wound dressing to reach the wound surface can be used tomonitor the amount of fluids (e.g., exudate and blood) emanating fromthe wound. Electrode-based moisture sensors are used to correlate woundmoisture levels and impedance in the sensor (see e.g., McColl et al.,“Monitoring Moisture without Disturbing the Wound Dressing,” Wounds UK5: 94-99, 2009 which is incorporated herein by reference) and woundmoisture levels are correlated with healing. For example, a rapidincrease in moisture level may indicate a microbial infection is present(see e.g., U.S. Pat. No. 6,963,772 to Bloom et al. titled“User-Retainable Temperature and Impedance Monitoring Methods andDevices,” which is incorporated herein by reference). Bacterial sensorsto detect proteins specific to Staphylococcus aureus and Pseudomonasaeruginosa, pathogens which frequently infect burn wounds, areconstructed within projections configured to extend into the wounddressing from the appurtenance surface. Information from these sensorsis transmitted to the microcontroller. For example, a nano-cantileverdevice that signals electronically when it binds a S. aureus antigen isconstructed using a carbon nanotube (see e.g., U.S. Pat. No. 7,612,424to Espinosa and Ke titled “Nanoelectromechanical Bistable CantileverDevice,” which is incorporated herein by reference). The nano-cantileveris functionalized with a monoclonal antibody specific forpoly-N-acetylglucosamine (PNAG), a S. aureus antigen (see Kelly-Quintoset al., “Characterization of the Opsonic and Protective Activity AgainstStaphylococcus aureus of Fully Human Monoclonal Antibodies Specific forthe Bacterial Surface Polysaccharide Poly-N-Acetylglucosamine” Infectionand Immunity 74: 2742-2750 (2006) which is incorporated herein byreference). An equivalent nano-cantilever device to detect P. aeruginosais constructed with a specific anti-P. aeruginosa monoclonal antibody(available from Abcam, San Francisco, Calif.). The bacterial sensors mayproject in different tubes or the same projection tube. When the sensorsencounter bacterial antigens, a signal is transmitted to themicrocontroller. A corresponding signal is then transmitted from theappurtenance to the local unit in response to a query signal from thelocal unit.

One part of the wound dressing becomes saturated with exudates fluidafter 16 hours and the proximal moisture sensor in the appurtenanceattached to that region of the wound dressing signals the local unit(programmed to interrogate the appurtenance every 4 hours) that thedressing is saturated. The local unit signals that a dressing needsattention with an LED light on the local unit and also sends a signalwith information regarding the RFID identity, patient ID and moisturesensor data to a central computer assembly. The central computerassembly is configured to alert hospital personnel. The information isalso automatically entered into the patient's electronic medical recordby the central computer assembly.

A nurse responds to the central computer assembly alert which has beensent to the nursing station. The nurse physically inspects the wounddressing identified by the alert information. The saturated portion ofthe wound dressing is removed and disposed of, with the appurtenancestill attached. The wound dressing is replaced and a new dressingappurtenance with a new RFID number and the patient's ID is inserted inthe new wound dressing.

Example 6 Wound Dressing Appurtenance Used to Monitor a Wound Dressingon an Individual with a Venous Leg Ulcer

An individual with a chronic wound, a venous leg ulcer, is treated inthe patient's home with a wound dressing and a wound dressingappurtenance system to monitor the wound dressing and indicate when thedressing needs attention. Information regarding a series of wounddressings over time is also automatically saved into the patient'smedical record for reference by medical personnel. The appurtenancesystem includes: a wound dressing appurtenance with a RFID sensor; alocal unit with a RFID reader and a central computer assembly associatedwith the patient's clinic or hospital.

The patient's leg ulcer is treated in the patient's home by a nurse, whochooses a wound dressing including absorbent padding and a short stretchbandage (available from Activa Healthcare). The appurtenance is insertedinto the dressing over the wound with a projection penetrating into thewound dressing. The appurtenance is fixed securely in place withadhesive on the flange of the device and by virtue of barbs on theoutside of the appurtenance that affix it securely to the wounddressing.

The disposable appurtenance includes a programmable RFID sensor device.The appurtenance is constructed with a RFID tag on a printed circuitboard with external sensors. For example, the appurtenance may contain adipole antenna of 22-gauge copper magnet wire, a rectifier to convertincoming UHF energy into DC, a capacitor to store the energy, and aprogrammable microcontroller to perform sensing and computation (seee.g., Sample et al., “Design of an RFID-Based Battery-Free ProgrammableSensing Platform,” IEEE Trans. Instr. Meas. 57: 2608-2615, 2008 which isincorporated herein by reference). A moisture sensor comprised of twoelectrodes which project into the wound dressing can be used to monitorthe amount of fluids (e.g., exudate and blood) emanating from the woundinto the dressing. The electrode-based moisture sensor correlatesmoisture levels and impedance in the sensor (see e.g., McColl et al.,Wounds UK 5: 94-99, 2009 which is incorporated herein by reference).Wound moisture levels are correlated with healing, and a rapid increasein moisture level, may indicate a microbial infection is present (seee.g., U.S. Pat. No. 6,963,772 issued to Bloom et al. on Nov. 8, 2005which is incorporated herein by reference).

The nurse installs the appurtenance system in the patient's home toallow remote monitoring of the leg ulcer. After manually pushing theappurtenance into the wound dressing, a local unit is used to query theappurtenance for its unique identification code and then to monitor theappurtenance. A local unit including a mobile RFID reader is installedin the patient's home. For example, a long range RFID reader operatingin the UHF band with an input/output interface for the internet isavailable from GAO RFID Inc. The local unit transmits UHF waves (e.g.,approximately at 902-928 MHz) from the bedside, a chair, or a table(e.g., within 10-15 meters of the wound dressing with the affixedappurtenance). The local unit is programmed by the nurse using a laptopcomputer to enter the RFID number, patient identification, and schedulefor appurtenance interrogation (e.g., every 2 hours). The nurse alsoestablishes a link between the local unit and a central computerassembly affiliated with the hospital or clinic. For example, a link tothe patient's internet service is established to transmit data from thelocal unit to the central computer assembly. Information from the localunit may also be configured to automatically be included in thepatient's electronic health record by the central computer assembly.

If the moisture sensor of the appurtenance detects excess moisture inthe wound dressing, an alert is signaled to the patient and thehospital's central computer. The local unit receives a signal of excessmoisture (i.e., low impedance) from the moisture sensor in theappurtenance and an LED on the local unit alerts the patient or a familymember that the wound dressing needs attention. Also the local unittransmits the signal of excess moisture to the central computer assemblywhere an alert (e.g., an e-mail) is created for the nurses on duty.

The nurse receiving the alert can contact the patient and/or the patientcan phone the nurse when the LED on the local unit lights up. The nursecan recommend the patient change the dressing or visit the patient tochange the dressing and inspect the wound directly. The nurse, thepatient or another caregiver can change the dressing and insert a newappurtenance in the dressing over the wound site. The new dressingappurtenance is verified by interrogating the new appurtenance with thelocal unit and the information is sent to the central computer assembly.

All of the above U.S. patents, U.S. patent application publications,U.S. patent applications, foreign patents, foreign patent applicationsand non-patent publications referred to in this specification and/orlisted in any Application Data Sheet, are incorporated herein byreference, to the extent not inconsistent herewith.

While various aspects and embodiments have been disclosed herein, otheraspects and embodiments will be apparent to those skilled in the art.The various aspects and embodiments disclosed herein are for purposes ofillustration and are not intended to be limiting, with the true scopeand spirit being indicated by the following claims.

What is claimed is: 1.-91. (canceled)
 92. A method of monitoring anappurtenance attached to a wound dressing, comprising: transmitting afirst signal configured to be received by an appurtenance attached to awound dressing, the appurtenance including an appurtenance surfacepositioned and configured to abut and adhesively attach to an outersurface of the wound dressing and a region extending into an interiorregion of the wound dressing a selected depth which samples a fluidassociated with a wound; receiving a first signal from the appurtenance,wherein the first signal includes information related to the wound orwound dressing; associating a first time point with the receipt of thefirst signal from the appurtenance; transmitting a second signalconfigured to be received by the appurtenance; receiving a second signalfrom the appurtenance, wherein the second signal includes informationrelated to the wound or wound dressing; and associating a second timepoint with the receipt of the second signal.
 93. The method of claim 92,wherein the transmitting a first signal comprises: transmitting a radiofrequency signal in the ultra high frequency (UHF) range.
 94. The methodof claim 92, wherein the transmitting a first signal comprises:transmitting a radio frequency signal in the near field communication(NFC) range.
 95. (canceled)
 96. The method of claim 92, wherein thetransmitting a first signal comprises: accepting input regardingparameters for monitoring the wound dressing at a local unit; andtransmitting a first signal from the local unit in response to theparameters for monitoring the wound dressing.
 97. The method of claim92, wherein the transmitting a first signal comprises: transmitting afirst signal from a local unit in accordance with a preset program ofsignal transmission. 98-99. (canceled)
 100. The method of claim 92,wherein the receiving a first signal from the appurtenance comprises:receiving a reflectively transmitted signal.
 101. (canceled)
 102. Themethod of claim 92, wherein the associating a first time point with thereceipt of the first signal from the appurtenance comprises: associatinga clock time point.
 103. The method of claim 92, wherein the associatinga first time point with the receipt of the first signal from theappurtenance comprises: associating a start time point. 104.-106.(canceled)
 107. The method of claim 92, wherein the transmitting asecond signal comprises: transmitting a second signal from a local unitin accordance with a preset program of signal transmission. 108.(canceled)
 109. The method of claim 92, wherein the receiving a secondsignal from the appurtenance comprises: receiving a radio frequencysignal in the ultra high frequency (UHF) range.
 110. The method of claim92, wherein the receiving a second signal from the appurtenancecomprises: receiving a radio frequency signal in the near fieldcommunication (NFC) range.
 111. (canceled)
 112. The method of claim 92,wherein the receiving a second signal from the appurtenance comprises:receiving a reflectively transmitted signal. 113.-116. (canceled) 117.The method of claim 92, comprising: comparing the second signal from theappurtenance with the first signal from the appurtenance to form asignal comparison; comparing the signal comparison with a preset table;and activating an indicator in accord with the preset table. 118.(canceled)
 119. The method of claim 92, comprising: receivinginformation regarding an individual associated with the appurtenance;associating information regarding the individual with a set of woundcriteria; comparing the second signal with the set of wound criteria;and activating an indicator in response to the comparison.
 120. Themethod of claim 92, comprising: receiving information regarding anindividual associated with the appurtenance; associating informationregarding the individual with a set of time point criteria; comparingthe second time point with the set of time point criteria; andactivating an indicator in response to the comparison.
 121. The methodof claim 92, comprising: accepting input including an individualidentifier associated with the appurtenance. 122.-123. (canceled) 124.The method of claim 92, comprising: transmitting a third signalconfigured to be received by the appurtenance to the wound dressing;receiving a third signal from the appurtenance; associating a third timepoint with receipt of the third signal; and activating an indicator.125.-128. (canceled)
 129. A method of monitoring an appurtenanceattached to a wound dressing, comprising: transmitting a first signalfrom a local unit, the first signal configured to be received by anappurtenance attached to a wound dressing, the appurtenance including anappurtenance surface positioned and configured to abut and adhesivelyattach to an outer surface of the wound dressing and a region extendinginto an interior region of the wound dressing a selected depth whichsamples a fluid associated with a wound; receiving a first signal fromthe appurtenance at the local unit, wherein the first signal includesinformation related to the wound or wound dressing; transmittinginformation regarding the first signal from the local unit to a centralassembly; associating a first time point with a receipt of the firstsignal; transmitting a second signal from the local unit, the secondsignal configured to be received by the appurtenance; receiving a secondsignal from the appurtenance at the local unit, wherein the secondsignal includes information related to the wound or wound dressing;transmitting information regarding the second signal from the local unitto the central assembly; and associating a second time point with areceipt of the second signal.
 130. The method of claim 129, wherein thetransmitting a first signal from a local unit comprises: transmitting aradio frequency signal in the ultra high frequency (UHF) range.
 131. Themethod of claim 129, wherein the transmitting a first signal from alocal unit comprises: transmitting a radio frequency signal in the nearfield communication (NFC) range.
 132. The method of claim 129, whereinthe transmitting a first signal from a local unit comprises:transmitting a first signal from the local unit in response to an inputat the local unit.
 133. The method of claim 129, wherein thetransmitting a first signal from a local unit comprises: transmitting afirst signal from the local unit in accordance with a preset program ofsignal transmission.
 134. The method of claim 129, wherein thetransmitting a first signal from a local unit comprises: accepting inputregarding one or more parameters for monitoring the wound dressing atthe local unit; and transmitting a first signal from the local unit inresponse to the one or more parameters for monitoring the wounddressing.
 135. The method of claim 129, wherein the transmitting a firstsignal from a local unit comprises: accepting input regarding one ormore parameters for monitoring the wound dressing at the centralassembly; transmitting information regarding the accepted input to thelocal unit; and transmitting a first signal from the local unit inresponse to the information regarding the accepted input.
 136. Themethod of claim 129, wherein the receiving a first signal from theappurtenance at the local unit comprises: receiving a radio frequencysignal in the ultra high frequency (UHF) range.
 137. The method of claim129, wherein the receiving a first signal from the appurtenance at thelocal unit comprises: receiving a radio frequency signal in the nearfield communication (NFC) range.
 138. The method of claim 129, whereinthe receiving a first signal from the appurtenance at the local unitcomprises: receiving a reflectively transmitted signal. 139.-140.(canceled)
 141. The method of claim 129, wherein the transmitting asecond signal from the local unit comprises: transmitting a secondsignal from the local unit in response to an input at the local unit.142. The method of claim 129, wherein the transmitting a second signalfrom the local unit comprises: transmitting a second signal from thelocal unit in accordance with a preset program of signal transmission.143. The method of claim 129, wherein the receiving a second signal fromthe appurtenance at the local unit comprises: receiving a reflectivelytransmitted signal.
 144. The method of claim 129, wherein thetransmitting information regarding the first signal from the local unitto the central assembly comprises: transmitting information through awired connection.
 145. The method of claim 129, wherein the transmittinginformation regarding the first signal from the local unit to thecentral assembly comprises: transmitting information through a wirelessconnection. 146.-150. (canceled)
 151. A method of monitoring anappurtenance attached to a wound dressing, comprising: receiving a firsttransmission from a local unit, the first transmission including firstinformation regarding an appurtenance attached to a wound dressing, theappurtenance including an appurtenance surface positioned and configuredto abut and adhesively attach to an outer surface of the wound dressingand a region extending into an interior region of the wound dressing aselected depth which samples a fluid associated with a wound;associating a first time point with the receipt of the firsttransmission; associating wound dressing parameters with the receivedfirst information regarding the appurtenance; determining, based on theassociated wound dressing parameters and the received first information,a first status of the appurtenance; determining, based on the determinedfirst status of the appurtenance, a first response; saving into memoryas a record of the appurtenance the first time point, the received firstinformation and the associated wound dressing parameters; receiving asecond transmission from the local unit, the second transmissionincluding second information regarding the appurtenance attached to thewound dressing; associating a second time point with the receipt of thesecond transmission; associating the record of the appurtenance with thereceived second information regarding the appurtenance; determining,based on the associated record and the received second information, asecond status of the appurtenance; determining, based on the determinedsecond status of the appurtenance, a second response; and saving intomemory as a record of the appurtenance the second time point and thereceived second information.
 152. The method of claim 151, wherein theassociating a first time point with the receipt of the firsttransmission comprises: associating a clock time point.
 153. The methodof claim 151, wherein the associating a first time point with thereceipt of the first transmission comprises: associating a relative timepoint.
 154. The method of claim 151, wherein the associating wounddressing parameters with the received first information regarding theappurtenance comprises: utilizing a table to determine the wounddressing parameters.
 155. The method of claim 151, wherein theassociating a second time point with the receipt of the secondtransmission comprises: associating a clock time point.
 156. The methodof claim 151, wherein the associating a second time point with thereceipt of the second transmission comprises: associating a relativetime point.
 157. The method of claim 151, comprising: accepting inputregarding one or more parameters for monitoring the wound dressing. 158.The method of claim 151, comprising: initiating a display of the firstresponse.
 159. The method of claim 151, comprising: initiating a displayof the second response.
 160. The method of claim 151, comprising:transmitting information to the local unit.
 161. The method of claim151, comprising: accepting input regarding a query of the determinedsecond status of the appurtenance; and initiating a display of thedetermined second status.